Peep Vain - the Best-known Training Guru in the Baltics = Peep Vain - Baltikumi tuntuim koolitusguru / Marit Sillavee

Index Scriptorium Estoniae

Sillavee, Marit

2006-01-01

Koolitusfirma Vain & Partnerid osaniku Peep Vainu karjäärist ja koolitajatööst. Vt. samas: Spiritual Trainer toTop Sportsmen = Tippsportlaste vaimutreener ; Lead Billing in Estonia's Highest-Grossing Documentary = Eesti edukaima dokfilmi peategelane

Effect of PEEP, blood volume, and inspiratory hold maneuvers on venous return.

Science.gov (United States)

Berger, David; Moller, Per W; Weber, Alberto; Bloch, Andreas; Bloechlinger, Stefan; Haenggi, Matthias; Sondergaard, Soren; Jakob, Stephan M; Magder, Sheldon; Takala, Jukka

2016-09-01

According to Guyton's model of circulation, mean systemic filling pressure (MSFP), right atrial pressure (RAP), and resistance to venous return (RVR) determine venous return. MSFP has been estimated from inspiratory hold-induced changes in RAP and blood flow. We studied the effect of positive end-expiratory pressure (PEEP) and blood volume on venous return and MSFP in pigs. MSFP was measured by balloon occlusion of the right atrium (MSFPRAO), and the MSFP obtained via extrapolation of pressure-flow relationships with airway occlusion (MSFPinsp_hold) was extrapolated from RAP/pulmonary artery flow (QPA) relationships during inspiratory holds at PEEP 5 and 10 cmH2O, after bleeding, and in hypervolemia. MSFPRAO increased with PEEP [PEEP 5, 12.9 (SD 2.5) mmHg; PEEP 10, 14.0 (SD 2.6) mmHg, P = 0.002] without change in QPA [2.75 (SD 0.43) vs. 2.56 (SD 0.45) l/min, P = 0.094]. MSFPRAO decreased after bleeding and increased in hypervolemia [10.8 (SD 2.2) and 16.4 (SD 3.0) mmHg, respectively, P waterfall. Copyright © 2016 the American Physiological Society.

Short outlines of books by Estonian authors : [annotations] / Rutt Hinrikus, Janika Kronberg

Index Scriptorium Estoniae

Hinrikus, Rutt, 1946-

1999-01-01

Ehin, Andres. Seljatas sada meest; Ilmet, Peep. Tuuldunud luule; Kaplinski, Jaan. Öölinnud. Öömõtted; Kender, Kaur. Iseseisvuspäev; Kesküla, Kalev. Vabariigi laulud; Luik, Viivi. Maa taevas; Nõu, Helga. Hundi silmas; Raun, Mait. Wake up; Remsu, Olev. Haapsalu tragöödia; Sauter, Peeter. Kogu moos; Undusk, Jaan. Maagiline müstiline keel; Vint, Toomas. Kunstnikuromaan

Peep Aaviksoo kukutas EMT-kesksus / Jaan Männik ; interv. Vallo Toomet

Index Scriptorium Estoniae

Männik, Jaan, 1945-

2003-01-01

EMT nõukogu esimees ja Eesti Telekomi juhatuse esimees Jaan Männik vastab küsimustele, mis on seotud Peep Aaviksoo lahkumisega Eesti Mobiiltelefoni juhi kohalt. Vt. samas: Aaviksoo selgitab lahkumise põhjusi. Peep Aaviksoo kiri. Kommenteerivad Radiolinja Eesti juhatuse esimees Sami Seppänen, Tele2 Eesti juhatuse esimees Üllar Jaaksoo, Ühispanga analüütik Sven Kunsing

Effects of peep on lung injury, pulmonary function, systemic circulation and mortality in animals with uninjured lungs-a systematic review

NARCIS (Netherlands)

Algera, Anna Geke; Pisani, Luigi; Chaves, Renato Carneiro de Freitas; Amorim, Thiago Chaves; Cherpanath, Thomas; Determann, Rogier; Dongelmans, Dave A.; Paulus, Frederique; Tuinman, Pieter Roel; Pelosi, Paolo; Gama de Abreu, Marcelo; Schultz, Marcus J.; Serpa Neto, Ary

2018-01-01

2O, in the 'high PEEP' or 'PEEP' arms, and in the 'low PEEP' or 'no PEEP' arms, respectively. Definitions used for lung injury were quite diverse, as were other outcome measures. The effects of PEEP, at any level, on lung injury was not straightforward, with some trials showing less injury with

Valgas võtab maavanema ameti üle Kalev Härk / Maria-Elisa Rannajõe

Index Scriptorium Estoniae

Rannajõe, Maria-Elisa

2007-01-01

Valga maavanema kohusetäitjaks saab maavalitsuse arengu- ja planeeringuosakonna juhataja Kalev Härk, praegu maavanema kohuseid täitev Tõnis Lass läheb puhkusele. Valga maavanem Georg Trashanov on kriminaalmenetluse ajaks töökohalt kõrvaldatud

Remo Holsmer: mees Kalevi pingi taga / Remo Holsmer ; interv. Peep Lillemägi

Index Scriptorium Estoniae

Holsmer, Remo, 1980-

2009-01-01

Reformierakonna Tallinna piirkonnajuht Remo Holsmer vastab küsimustele, mis puudutavad tema tööd Kalevi korvpalliklubi managerina, korvpalli taset Eestis, Kalevisse välismängijate leidmist, Tallinna Kalev-Tartu Rock vastasseisu ning suhteid Jaak Salumetsaga

Tallinna Ülikool / Leif Kalev, Anneli Leinpere, Tiit Land, Alessandro Centonze, Hannes Palang, Liis Kelberg

Index Scriptorium Estoniae

2008-01-01

Ülikooli ja seal õpetatavaid erialasid tutvustavad dotsent Leif Kalev, kunstimagistrant Anneli Leinpere, professor Tiit Land, välisüliõpilane Milanost Alessandro Centonze, vanemteadur Hannes Palang ning kirjaliku tõlke magistrant Liis Kelberg

PEEP-ZEEP technique: cardiorespiratory repercussions in mechanically ventilated patients submitted to a coronary artery bypass graft surgery

Directory of Open Access Journals (Sweden)

Auler José

2011-09-01

Full Text Available Abstract Background The PEEP-ZEEP technique is previously described as a lung inflation through a positive pressure enhancement at the end of expiration (PEEP, followed by rapid lung deflation with an abrupt reduction in the PEEP to 0 cmH2O (ZEEP, associated to a manual bilateral thoracic compression. Aim To analyze PEEP-ZEEP technique's repercussions on the cardio-respiratory system in immediate postoperative artery graft bypass patients. Methods 15 patients submitted to a coronary artery bypass graft surgery (CABG were enrolled prospectively, before, 10 minutes and 30 minutes after the technique. Patients were curarized, intubated, and mechanically ventilated. To perform PEEP-ZEEP technique, saline solution was instilled into their orotracheal tube than the patient was reconnected to the ventilator. Afterwards, the PEEP was increased to 15 cmH2O throughout 5 ventilatory cycles and than the PEEP was rapidly reduced to 0 cmH2O along with manual bilateral thoracic compression. At the end of the procedure, tracheal suction was accomplished. Results The inspiratory peak and plateau pressures increased during the procedure (p Conclusion The PEEP-ZEEP technique seems to be safe, without alterations on hemodynamic variables, produces elevated expiratory flow and seems to be an alternative technique for the removal of bronchial secretions in patients submitted to a CABG.

The Neopuff's PEEP valve is flow sensitive.

LENUS (Irish Health Repository)

Hawkes, Colin Patrick

2011-03-01

The current recommendation in setting up the Neopuff is to use a gas flow of 5-15 L\\/min. We investigated if the sensitivity of the positive end expiratory pressure (PEEP) valve varies at different flow rates within this range.

Differential Effects of Intraoperative Positive End-expiratory Pressure (PEEP) on Respiratory Outcome in Major Abdominal Surgery Versus Craniotomy

DEFF Research Database (Denmark)

de Jong, Myrthe A C; Ladha, Karim S; Melo, Marcos F Vidal

2015-01-01

OBJECTIVES: In this study, we examined whether (1) positive end-expiratory pressure (PEEP) has a protective effect on the risk of major postoperative respiratory complications in a cohort of patients undergoing major abdominal surgeries and craniotomies, and (2) the effect of PEEP is differed......: Within the entire study population (major abdominal surgeries and craniotomies), we found an association between application of PEEP ≥5 cmH2O and a decreased risk of postoperative respiratory complications compared with PEEP 5 cmH2O was associated with a significant lower...... undergoing major abdominal surgery. Our data suggest that default mechanical ventilator settings should include PEEP of 5-10 cmH2O during major abdominal surgery....

Peep Põldsamm lõi kampa Skype'i loojatega

Index Scriptorium Estoniae

2008-01-01

Peep Põldsamm asus juhtima Modesat Communications OÜd, mille omanik on Skype'i kaasasutajatele kuuluv investeerimisfirma Ambient Sound Investments. Modesat plaanib saavutada modemitehnoloogia rahvusvahelisel turul viieprotsendilise turuosa. Vt. samas: Põldsamm: olen uute äride ülesehitaja

Evaluation of lung and chest wall mechanics during anaesthesia using the PEEP-step method.

Science.gov (United States)

Persson, P; Stenqvist, O; Lundin, S

2018-04-01

Postoperative pulmonary complications are common. Between patients there are differences in lung and chest wall mechanics. Individualised mechanical ventilation based on measurement of transpulmonary pressures would be a step forward. A previously described method evaluates lung and chest wall mechanics from a change of ΔPEEP and calculation of change in end-expiratory lung volume (ΔEELV). The aim of the present study was to validate this PEEP-step method (PSM) during general anaesthesia by comparing it with the conventional method using oesophageal pressure (PES) measurements. In 24 lung healthy subjects (BMI 18.5-32), three different sizes of PEEP steps were performed during general anaesthesia and ΔEELVs were calculated. Transpulmonary driving pressure (ΔPL) for a tidal volume equal to each ΔEELV was measured using PES measurements and compared to ΔPEEP with limits of agreement and intraclass correlation coefficients (ICC). ΔPL calculated with both methods was compared with a Bland-Altman plot. Mean differences between ΔPEEP and ΔPL were mechanical properties among the lung healthy patients stresses the need for individualised ventilator settings based on measurements of lung and chest wall mechanics. The agreement between ΔPLs measured by the two methods during general anaesthesia suggests the use of the non-invasive PSM in this patient population. NCT 02830516. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Miljonitehing : Kalev müüdud - jumal tänatud, kõik murest lahti / Andres Reimer, Holger Roonemaa, Vallo Toomet

Index Scriptorium Estoniae

Reimer, Andres

2007-01-01

Kalevi ja Tere toiduainetööstusettevõtete müügist investeerimisfirmale Alta Capital Partners. Vt. samas: Alta Capital Partners; Holger Roonemaa, Kristjan Jõevere. Finantsinspektsioon: Kalev rikkus head tava

English for lawyers / Liina Soobik ; [preface: Peep Pruks

Index Scriptorium Estoniae

Soobik, Liina, 1955-

2001-01-01

Kasutatud tekstide autorid: Peep Pruks, Merit-Ene Ilja, Ilona Nurmela, Kristi Raba, Andreas Kangur, Raul Narits, Peeter Roosma, Kalle Merusk, Maret Altnurme, Jaan Ginter, Aare Tark, Norman Aas, Lasse Lehis, Hannes Veinla, Jaan Sootak, Eerik Kergandberg, Paul Varul, Jaanus Ots, Urve Liin, Irene Kull, Merle Muda, Gaabriel Tavits, Andres Vutt, Kadri Siibak, Ellen Ridaste, Heiki Pisuke, Andrus Siibak

Lugejate valik : Peep Vain on parim / Marko Liibak

Index Scriptorium Estoniae

Liibak, Marko

2007-01-01

Aripaev.ee ja ajaleht Äripäev korraldasid lugejate seas küsitluse, mille käigus valiti Eesti parimaks koolitajaks Vain & Partnerite omanik ning koolituskonsultant Peep Vain. Teisele kohale tuli koolitaja, juhtimiskonsultant ja nõustaja ning Tallinn Ülikooli kliinilise psühholoogia professor Mare Pork. Järgnesid Ülo Vihma, Indrek Saul, Tiit Valm, Mihkel Pärjamäe ning Alexander Kotchubei

Voyeuristi alla finestra: Peeping Tom, dalla leggenda al cinema

Directory of Open Access Journals (Sweden)

Laura Staiano

2015-01-01

Full Text Available This essay deals with voyeuristic attitudes and ʹscopic powerʹ, i.e. the power to gaze at forbidden things and people without being seen. Indeed, its object par excellence coincides with female nakedness, while its subject is an invisible masculinity, which takes delight in looking. The paper is based on a study of the Anglo-Saxon legend of Lady Godiva and it is strictly connected with the subject of my dissertation in progress – metaphorical and physical blindness in 18th century French literature (since several voyeurs got blind because of their instincts and desires. Lady Godiva’s voyeur, called Peeping Tom, is struck blind for having looked out of his window and seen the noblewoman riding naked. This legend has inspired many artists in different fields, and nowadays its heroine is very famous and venerated. In particular, this essay focuses on the relation between this legend and compulsive looking (or scopophilia in two renowned films, Rear Window by Alfred Hitchcock, and Peeping Tom by Michael Powell.

Effect of PEEP and inhaled nitric oxide on pulmonary gas exchange during gaseous and partial liquid ventilation with small volumes of perfluorocarbon.

Science.gov (United States)

Max, M; Kuhlen, R; Falter, F; Reyle-Hahn, M; Dembinski, R; Rossaint, R

2000-04-01

Partial liquid ventilation, positive end-expiratory pressure (PEEP) and inhaled nitric oxide (NO) can improve ventilation/perfusion mismatch in acute lung injury (ALI). The aim of the present study was to compare gas exchange and hemodynamics in experimental ALI during gaseous and partial liquid ventilation at two different levels of PEEP, with and without the inhalation of nitric oxide. Seven pigs (24+/-2 kg BW) were surfactant-depleted by repeated lung lavage with saline. Gas exchange and hemodynamic parameters were assessed in all animals during gaseous and subsequent partial liquid ventilation at two levels of PEEP (5 and 15 cmH2O) and intermittent inhalation of 10 ppm NO. Arterial oxygenation increased significantly with a simultaneous decrease in cardiac output when PEEP 15 cmH2O was applied during gaseous and partial liquid ventilation. All other hemodynamic parameters revealed no relevant changes. Inhalation of NO and instillation of perfluorocarbon had no additive effects on pulmonary gas exchange when compared to PEEP 15 cmH2O alone. In experimental lung injury, improvements in gas exchange are most distinct during mechanical ventilation with PEEP 15 cmH2O without significantly impairing hemodynamics. Partial liquid ventilation and inhaled NO did not cause an additive increase of PaO2.

Pronkssõduri teisaldamise ainsaks eelduseks on referendum / Kalev Rebane, Roman Zharov, Aleksandr Korobov...[jt.] ; interv. Peeter Ernits, Jüri Aarma, Annika Poldre

Index Scriptorium Estoniae

2006-01-01

Oma seisukohtadest Tallinnas Tõnismäel asuva Teise maailmasõja mälestusmärgi suhtes räägivad isamaaliitlane Kalev Rebane ja vene noorteühenduse Notshnoi Dozor juhid Roman Zharov, Aleksandr Korobov, Oleg Filippov ja Igor Rogo

FCT (functional computed tomography) evaluation of the lung volumes at different PEEP (positive-end expiratory pressure) ventilation pattern, in mechanical ventilated patients

International Nuclear Information System (INIS)

Papi, M.G.; Di Segni, R.; Mazzetti, G.; Staffa, F.; Conforto, F.; Calimici, R.; Salvi, A.; Matteucci, G.

2007-01-01

Purpose To evaluate with FCT (functional computed tomography) total lung volume and fractional lung volumes at different PEEP (positive end expiratory pressure) values in acute mechanically ventilated patients. Methods Nine ICU (intensive care unity) patients (1 lung pneumonia, 2 polytrauma, 2 sepsis, 3 brain surgery, 1 pulmonary embolism); mean age 48 ± 15 years, 6 male, 3 female; GE 16 MDCT scan was performed with acquisition from apex to diaphragma in seven seca at different PEEP values. Raw CT data were analysed by an advantage workstation to obtain volume density masks and histograms of both lungs and each lung and these density ranges were applied: - 1000 - 950 hyper-ventilated lung, -900 - 650 well aerated lung, -950 - 500 all aerated lung, -500 + 200 lung tissue. Total and fractional lung volumes, Hounsfield unit (HU) were calculated and compared at different PEEP values (0, 5, 10, 15 cm H 2 O). In four patients lung volumes were compared between the more and the less involved lung at increased PEEP. Statistic analysis: comparison means-medians tests. Results Data calculated at five PEEP showed unexpected decrease of total lung volume and increase of lung density (HU); proportionally no significant improvement of oxigenation. (orig.)

FCT (functional computed tomography) evaluation of the lung volumes at different PEEP (positive-end expiratory pressure) ventilation pattern, in mechanical ventilated patients

Energy Technology Data Exchange (ETDEWEB)

Papi, M.G.; Di Segni, R.; Mazzetti, G.; Staffa, F. [Dept. of Radiology, S. Giovanni HS, Rome (Italy); Conforto, F.; Calimici, R.; Salvi, A. [Dept. of Anesthesiology, S. Giovanni HS, Rome (Italy); Matteucci, G. [Dept. of Pneumology, S. Giovanni HS, Rome (Italy)

2007-06-15

Purpose To evaluate with FCT (functional computed tomography) total lung volume and fractional lung volumes at different PEEP (positive end expiratory pressure) values in acute mechanically ventilated patients. Methods Nine ICU (intensive care unity) patients (1 lung pneumonia, 2 polytrauma, 2 sepsis, 3 brain surgery, 1 pulmonary embolism); mean age 48 {+-} 15 years, 6 male, 3 female; GE 16 MDCT scan was performed with acquisition from apex to diaphragma in seven seca at different PEEP values. Raw CT data were analysed by an advantage workstation to obtain volume density masks and histograms of both lungs and each lung and these density ranges were applied: - 1000 - 950 = hyper-ventilated lung, -900 - 650 well aerated lung, -950 - 500 all aerated lung, -500 + 200 lung tissue. Total and fractional lung volumes, Hounsfield unit (HU) were calculated and compared at different PEEP values (0, 5, 10, 15 cm H{sub 2}O). In four patients lung volumes were compared between the more and the less involved lung at increased PEEP. Statistic analysis: comparison means-medians tests. Results Data calculated at five PEEP showed unexpected decrease of total lung volume and increase of lung density (HU); proportionally no significant improvement of oxigenation. (orig.)

Bussijuhtide kindrali rasked päevad / Peep Peterson ; interv. Tanel Raig

Index Scriptorium Estoniae

Peterson, Peep, 1975-

2007-01-01

Eesti Transpordi- ja Teetöötajate Ametiühingu esimees Peep Peterson vastab bussijuhtide ja tööandjate vahelisi lahkhelisid, ametiühinguliikumist ning kokkuleppe sõlmimist puudutavatele küsimustele. Kommenteerivad: Villem Tori. Streikija iseloomuga raske vastane; Henn Pärn. Peterson saavutas maksimumide maksimumi; Harri Taliga. Ametiühingu liidritel erinevad arusaamad. Lisa: Fakte eluloost

Raudna põhikooli spordihoone Heimtalis = Raudna School Sports Facility in Heimtali / Peep Jänes

Index Scriptorium Estoniae

Jänes, Peep, 1936-

2009-01-01

2008. a. valminud spordihoonest, mille autor on Peep Jänes, projekteerija GS-Dis, sisekujundajad Signe ja Gildardas Stokas. Spordihoone rajati 1860. a. ehitatud mõisa ringtalli välismüüri sisealale ja restaureeriti ajalooline ringmüür

Monitoring of intratidal lung mechanics: a Graphical User Interface for a model-based decision support system for PEEP-titration in mechanical ventilation.

Science.gov (United States)

Buehler, S; Lozano-Zahonero, S; Schumann, S; Guttmann, J

2014-12-01

In mechanical ventilation, a careful setting of the ventilation parameters in accordance with the current individual state of the lung is crucial to minimize ventilator induced lung injury. Positive end-expiratory pressure (PEEP) has to be set to prevent collapse of the alveoli, however at the same time overdistension should be avoided. Classic approaches of analyzing static respiratory system mechanics fail in particular if lung injury already prevails. A new approach of analyzing dynamic respiratory system mechanics to set PEEP uses the intratidal, volume-dependent compliance which is believed to stay relatively constant during one breath only if neither atelectasis nor overdistension occurs. To test the success of this dynamic approach systematically at bedside or in an animal study, automation of the computing steps is necessary. A decision support system for optimizing PEEP in form of a Graphical User Interface (GUI) was targeted. Respiratory system mechanics were analyzed using the gliding SLICE method. The resulting shapes of the intratidal compliance-volume curve were classified into one of six categories, each associated with a PEEP-suggestion. The GUI should include a graphical representation of the results as well as a quality check to judge the reliability of the suggestion. The implementation of a user-friendly GUI was successfully realized. The agreement between modelled and measured pressure data [expressed as root-mean-square (RMS)] tested during the implementation phase with real respiratory data from two patient studies was below 0.2 mbar for data taken in volume controlled mode and below 0.4 mbar for data taken in pressure controlled mode except for two cases with RMS rational decision-making model for PEEP-titration.

Effect of patient position and PEEP on hepatic, portal and central venous pressures during liver resection.

Science.gov (United States)

Sand, L; Rizell, M; Houltz, E; Karlsen, K; Wiklund, J; Odenstedt Hergès, H; Stenqvist, O; Lundin, S

2011-10-01

It has been suggested that blood loss during liver resection may be reduced if central venous pressure (CVP) is kept at a low level. This can be achieved by changing patient position but it is not known how position changes affect portal (PVP) and hepatic (HVP) venous pressures. The aim of the study was to assess if changes in body position result in clinically significant changes in these pressures. We studied 10 patients undergoing liver resection. Mean arterial pressure (MAP) and CVP were measured using fluid-filled catheters, PVP and HVP with tip manometers. Measurements were performed in the horizontal, head up and head down tilt position with two positive end expiratory pressure (PEEP) levels. A 10° head down tilt at PEEP 5 cm H(2) O significantly increased CVP (11 ± 3 to 15 ± 3 mmHg) and MAP (72 ± 8 to 76 ± 8 mmHg) while head up tilt at PEEP 5 cm H(2) O decreased CVP (11 ± 3 to 6 ± 4 mmHg) and MAP (72 ± 8 to 63 ± 7 mmHg) with minimal changes in transhepatic venous pressures. Increasing PEEP from 5 to 10 resulted in small increases, around 1 mmHg in CVP, PVP and HVP. There was no significant correlation between changes in CVP vs. PVP and HVP during head up tilt and only a weak correlation between CVP and HVP by head down tilt. Changes of body position resulted in marked changes in CVP but not in HVPs. Head down or head up tilt to reduce venous pressures in the liver may therefore not be effective measures to reduce blood loss during liver surgery. 2011 The Authors Acta Anaesthesiologica Scandinavica, 2011 The Acta Anaesthesiologica Scandinavica Foundation.

"THE EVALUATION OF THE POSSIBLE EFFECT OF POSITIVE END EXPIRATORY PRESSURE (PEEP ON PHARMACOKINETICS OF PHENYTOIN IN PATIENTS WITH ACUTE BRAIN INJURY UNDER MECHANICAL VENTILATION."

Directory of Open Access Journals (Sweden)

"Elham Hadidi

2005-04-01

Full Text Available Positive ventilation has shown to have an influence on pharmacokinetic and disposition of some drugs.Beacause phenytoin with a narrow therapautic range, is the most commonly used drug for prophylaxis and treatment of early seizures after acute brain injuries, in the present study the effect of short term PEEP (5-10 cm H2O for at least 8 hours on phenytoin serum concentration and pharmacokinetic parameters such as Vmax and clearance in brain injured patients under mechanical ventilation was examined. Ten patients with moderate to severe acute brain injury who were placed on mechanical ventilation with an initial PEEP level of 0-5 cm H2O were included in the study. Patients received phenytoin loading dose of 15 mg/kg followed by a maintenance daily dose of 3-7 mg/kg initiated within 12 hours of loading dose. Sampels were taken on two different occasions before and after PEEP elevation. Total phenytoin serum concentrations were determined by HPLC method. A time invarient Michaelis-Menten pharmacokinetic model was used to calculate Vmax and clearance for each patient.Derrived variables were calculated as follows: Vmax, 3.5-6.8 and 3.7-8.2 mg/kg/day; Clearance, 0.1-0.7 and 0.1-1.2 l/kg/day (before and after PEEP elevation, respectively. Our data have shown a wide range of variability (2.6-32.5 mg/l in phenytoin serum concentrations. There were no statistically significant differences in the measured total concentrations (p=0.721 and calculated Vmax and clearance (p=0.285before and after PEEP elevation. Administration of fluid and inotropic agents, limitation in application of higher levels of PEEP and drug interactions, shall be considered as possible explanations for these findings.

Ventilation area measured with eit in order to optimize peep settings in mechanically ventilated patients

NARCIS (Netherlands)

Blankman, P; Groot Jebbink, E; Preis, C; Bikker, I.; Gommers, D.

2012-01-01

INTRODUCTION. Electrical Impedance Tomography (EIT) is a non-invasive imaging technique, which can be used to visualize ventilation. Ventilation will be measured by impedance changes due to ventilation. OBJECTIVES. The aim of this study was to optimize PEEP settings based on the ventilation area of

Efecto del incremento de la PEEP en la actividad muscular respiratoria evaluado con electromiografía de superficie en individuos sanos bajo ventilación espontánea

Directory of Open Access Journals (Sweden)

Hernández-Valdivieso, Alher Mauricio

2016-07-01

Full Text Available Introduction: In a mechanically ventilated patient with increased airway resistance, the expiratory time span is insufficient to exhale all the inspired volume. In order to maintain oxygenation and to reduce the workload of respiratory muscles, it is common to apply an extrinsic positive end-expiratory pressure (PEEP that reduces tissue collapsibility, counterbalancing the increased resistance. Several studies have shown the usefulness of surface electromyography (sEMG to quantify the work of breathing (WOB, particularly in patients with obstructive diseases. Objective: To assess the effect of incremental PEEP in the respiratory muscle activity through sEMG in healthy volunteers noninvasively ventilated. Methods: Study of muscle activity in 10 healthy male volunteers, noninvasively ventilated for 20 minutes. The extrinsic PEEP was applied from 0 to 5 cm H2O in steps of 1 cm H2O at 30 seconds intervals. Results: The bio-potentials of diaphragm and sternocleidomastoid muscles revealed different breathing patterns in response to incremental PEEP: 1 increase in the workload of both muscles during inspiration and expiration; 2 increase in the workload of only one muscle; 3 a remarkable increase in muscle activity only in expiration. Conclusion: In noninvasively ventilated volunteers, sEMG quantitatively relates the PEEP level with changes in sternocleidomastoid and diaphragm activity.

Digimaks ei hakka põhjustama guugeldamisreise / Dmitri Jegorov

Index Scriptorium Estoniae

Jegorov, Dmitri

2017-01-01

Eesti digimajanduse maksustamise muutuste mõjust. Vastus Kaido Künnapas, Mihkel Miidla ja Paul Künnapi artiklile "Kas pärast digimaksu kehtestamist tuleb guugeldamiseks minna Rootsi reisile?". Eesti Päevaleht, 2017, 9. okt.

Rasked vestlused. Kuidas ma talle seda ütlen / Irene Metsis, Sami Seppänen, Peep Sooman ; intervjueerinud Heli Lehtsaar

Index Scriptorium Estoniae

Metsis, Irene

2009-01-01

Skanska EMV administratsioonijuhi Irene Metsise, AS-i Elisa Eesti tegevdirektori Sami Seppäneni ja Pindi Kinnisvara juhatuse liikme Peep Soomani soovitused negatiivse sõnumi edastamiseks töötajale. Vt. samas: 4 nõuannet juhile, kuidas end keeruliseks vestluseks ette valmistada

Mida arvate ideest, et kõrgkoole võiks juhtida ülikoolivälistest inimestest koosnev nõukogu? / Jaak Aaviksoo, Maris Mälzer, Peeter Kreitzberg, Peep Sürje

Index Scriptorium Estoniae

2010-01-01

Küsimusele vastavad Tartu Ülikooli eelmine rektor Jaak Aaviksoo, Eesti Üliõpilaskondade Liidu esimees Maris Mälzer, Riigikogu kultuurikomisjoni esimees Peeter Kreitzberg ja Tallinna Tehnikaülikooli rektor Peep Sürje

Kas omakeelsel haridusel ja teadusel on tulevikku? / Kirsti Siitonen, Jolanta Zabarskaite, Josep Soler-Carbonell, Rainer Enrique Hamel ; intervjueerinud Peep Nemvalts ; tõlkinud Doris Kareva, Aili Künstler

Index Scriptorium Estoniae

2011-01-01

TLÜ teaduskeelekeskus korraldas koos TLÜ eesti keele ja kultuuri instituudiga 29. ja 30. augustil rahvusvahelise konverentsi "Rahvuskeeled teaduses ja kõrghariduses". Sel teemal vastavad TLÜ teaduskeelekeskuse juhataja Peep Nemvaltsi küsimustele konverentsi rahvusvahelised esinejad

Фабрику Kalev продают норвежской фирме / Андрус Карнау, Райго Неудорф

Index Scriptorium Estoniae

Карнау, Андрус

2010-01-01

AS-i Kalev Chocolate Factory osta sooviv Orkla kontrerni esindajate kinnitusel hakatakse edaspidi toodangut eksportima nii Balti- kui Põhjamaadesse. Enne varade üleminekut uuele omanikule tuleb ära oodata Kalevi aktsiate aresti alt vabanemine

Uus töölpeinguseadus : nagu Soomes lama ajal? Ei, veel karmim / Maret Maripuu, Tarmo Kriis, Peep Peterson ; interv. Külli-Riin Tigasson

Index Scriptorium Estoniae

Maripuu, Maret, 1974-

2008-01-01

Uue töölepingu seaduse eelnõust. Vestlusringis on sotsiaalminister Maret Maripuu, Eesti tööandjate keskliidu juhataja Tarmo Kriis ja transpordi ametiühingu juhatuse esimees Peep Peterson. Lisatud: mida eelnõu muudab? ; ametiühingute keskliidu juhi Harri Taliga kommentaar: dzhungliseaduste tagasitulek? ; Helmes ASi nõukogu esimehe Jaan Pillesaare kommentaar: praegune seadus on tobe

Between preservation and transformation. First considerations about the recovery of the peep districts in Parma

Directory of Open Access Journals (Sweden)

Luca Gullì

2012-10-01

Full Text Available The regeneration policy of the PEEP districts, can contribute to the enrichment of the theoretical framework formulated for the protection of the heritage of the Modern Movement. In 2011, the Municipality of Parma, showing a new awareness in relation to assets until now rarely considered, devices a specific field of study within its structural urbanistic plan. In the absence of a regulatory framework of reference, it is crucial to build up the appropriate frameworks of knowledge directed to operational decisions. This can be done by specifically dedicated archives to which to entrust with the definition of a body of rules of urban planning and housing tailored to the particularities of these settlements and to the real questions of transformation that can arise in them.

Tusov tegi sõber Kruudaga head äri / Agnes Ojala

Index Scriptorium Estoniae

Ojala, Agnes

2008-01-01

Kalev Real Estate Company (Kalev REC) müüs BCA Center OÜ OÜ-le Raldon. Kalevi õigusteeninduse juht Allan Viirma selgitab ettevõtte müümist. Vt. samas: Kalev Spordis jääb spordile vähem ruumi

Kruuda lahkub Kalevi tütarettevõtete juhi kohalt

Index Scriptorium Estoniae

2006-01-01

Vt. ka Postimees : na russkom jazõke 28. juuli lk. 4. AS-i Kalev suuromanik Oliver Kruuda lahkub Kalevi tütarettevõtete AS Kalev Chocolate Factory, AS Kalev Jõhvi Tootmine ja AS Vilma juhataja kohalt, tütarfirmade juhatuse esimeheks nimetatakse Kalevi senine müügi- ja teenindusdirektor Kati Kusmin

"THE EVALUATION OF THE POSSIBLE EFFECT OF POSITIVE END EXPIRATORY PRESSURE (PEEP) ON PHARMACOKINETICS OF PHENYTOIN IN PATIENTS WITH ACUTE BRAIN INJURY UNDER MECHANICAL VENTILATION."

OpenAIRE

"Elham Hadidi; Mojtaba Mojtahedzadeh; Mohammad Reza Rouini; Behzad Eftekhar; Mohammad Abdollahi; Atabak Najafi; Mohammad R. Khajavi; Saeed Rezaee; Reza Ghaffari; Minoo Afshar"

2005-01-01

Positive ventilation has shown to have an influence on pharmacokinetic and disposition of some drugs.Beacause phenytoin with a narrow therapautic range, is the most commonly used drug for prophylaxis and treatment of early seizures after acute brain injuries, in the present study the effect of short term PEEP (5-10 cm H2O for at least 8 hours) on phenytoin serum concentration and pharmacokinetic parameters such as Vmax and clearance in brain injured patients under mechanical ventilation was e...

Evelin Ilves tegi transrasvadele ära

Index Scriptorium Estoniae

2010-01-01

Proua Evelin Ilves kritiseeris kommivabriku Kalev toodangut transrasvhapete sisalduse pärast. Kalev Chocolate Factory on nüüdseks kõigi oma maiustuste valmistamisel loobunud hüdrogeenimata taimsete rasvade kasutamisest

NOAA People Empowered Products (PeEP): Combining social media with scientific models to provide eye-witness confirmed products

Science.gov (United States)

Codrescu, S.; Green, J. C.; Redmon, R. J.; Minor, K.; Denig, W. F.; Kihn, E. A.

2013-12-01

NOAA products and alerts rely on combinations of models and data to provide the public with information regarding space and terrestrial weather phenomena and hazards. This operational paradigm, while effective, neglects an abundant free source of measurements: millions of eyewitnesses viewing weather events. We demonstrate the capabilities of a prototype People Empowered Product (PeEP) that combines the OVATION prime auroral model running at the NOAA National Geophysical Data Center with Twitter reports of observable aurora. We introduce an algorithm for scoring Tweets based on keywords to improve the signal to noise of this dynamic data source. We use the location of the aurora derived from this new database of crowd sourced observations to validate the OVATION model for use in auroral forecasting. The combined product displays the model aurora in real time with markers showing the location and text of tweets from people actually observing the aurora. We discuss how the application might be extended to other space weather products such as radiation related satellite anomalies.

Efeitos da compressão torácica manual versus a manobra de PEEP-ZEEP na complacência do sistema respiratório e na oxigenação de pacientes submetidos à ventilação mecânica invasiva Effects of manual rib-cage compression versus PEEP-ZEEP maneuver on respiratory system compliance and oxygenation in patients receiving mechanical ventilation

Directory of Open Access Journals (Sweden)

Flavio Renato Antunes dos Santos

2009-06-01

Full Text Available OBJETIVOS: Os pacientes com incapacidade de desempenhar suas funções ventilatórias podem ser submetidos à ventilação mecânica invasiva. A fisioterapia respiratória atua no tratamento destes pacientes com a finalidade de melhorar sua função pulmonar. O objetivo do estudo foi avaliar os efeitos da compressão torácica manual versus a manobra de pressão expiratória final positiva-pressão expiratória final zero (PEEP-ZEEP na complacência do sistema respiratório e na oxigenação de pacientes em ventilação mecânica invasiva. MÉTODOS: Foi realizado um estudo bicêntrico, prospectivo, randomizado e crossover, incluindo pacientes em ventilação mecânica invasiva em modo controlado por um período superior a 48 horas. Os protocolos de fisioterapia respiratória foram realizados de forma aleatória, com intervalo de 24 horas entre eles. Dados da complacência do sistema respiratório e da oxigenação foram coletados antes da aplicação dos protocolos e 30 minutos após a aplicação dos mesmos. RESULTADOS: Doze pacientes completaram o estudo. Na análise intragrupo, em ambas as técnicas houve aumento estatisticamente significativo do volume corrente (p=0,002, da complacência estática (p=0,002 e complacência dinâmica (p=0,002. Com relação à oxigenação, no grupo compressão torácica manual, a saturação periférica de oxigênio aumentou com diferença significativa (p=0,011. CONCLUSÕES: A compressão torácica manual e a manobra de PEEP-ZEEP têm efeitos clínicos positivos e não diferem entre si. Em relação à oxigenação encontramos um comportamento favorável da saturação periférica de oxigênio no grupo compressão torácica manual.OBJECTIVES: Patients unable to perform breathing functions may be submitted to invasive mechanical ventilation. Chest physiotherapy acts directly on the treatment of these patients for the purpose of improving their lung function. The objective of this study was to evaluate the

Kruuda ostab Werolit Sõõrumaa abil / Martin Hanson

Index Scriptorium Estoniae

Hanson, Martin, 1984-

2006-01-01

Kondiitritööstus Kalev teatas, et sõlmis kokkuleppe U.S. Invest AS-iga, mille kohaselt AS Kalev omandab 50% suuruse osaluse Weroli aktsiatele kõrgeima pakkumise teinud Dovelin Baltic OÜ-s, mis kuulub Urmas Sõõrumaale

Vilma lõpetab leivateo / Marko Suurmägi

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Suurmägi, Marko, 1975-

2008-01-01

Vilma emafirma Kalev Chocolate Factory juhatuse liikme Mait Nilsoni sõnul jagab Kalev jahutoodete tegemise Jõhvi ja Viljandi ettevõtte vahel nii, et leiba ja saia hakatakse küpsetama Jõhvis ning Viljandisse koondub tortide, kookide ja jahusegude valmistamine. Lisa: Ajalugu

Evelin Ilves: Kalevi kommid on kräpp / Arvo Uustalu

Index Scriptorium Estoniae

Uustalu, Arvo, 1964-

2009-01-01

Proua Evelin Ilves kritiseeris kommivabriku Kalev toodangut transrasvhapete sisalduse pärast. Kommenteerivad ASi Kalev Chocolate Factory turundus- ja müügidirektor Monika Heinrand, suhtekorraldaja Ruth Roht ning toitumisteadlased Selma Teesalu, Mai Maser ja Tagli Pitsi. Vt. samas: Transrasvad põhjustavad rasvumist

Hemodynamic responses to external counterbalancing of auto-positive end-expiratory pressure in mechanically ventilated patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Baigorri, F; de Monte, A; Blanch, L; Fernández, R; Vallés, J; Mestre, J; Saura, P; Artigas, A

1994-11-01

To study the effect of positive end-expiratory pressure (PEEP) on right ventricular hemodynamics and ejection fraction in patients with chronic obstructive pulmonary disease and positive alveolar pressure throughout expiration by dynamic hyperinflation (auto-PEEP). Open, prospective, controlled trial. General intensive care unit of a community hospital. Ten patients sedated and paralyzed with an acute exacerbation of chronic obstructive pulmonary disease undergoing mechanical ventilation. Insertion of a pulmonary artery catheter modified with a rapid response thermistor and a radial arterial catheter. PEEP was then increased from 0 (PEEP 0) to auto-PEEP level (PEEP = auto-PEEP) and 5 cm H2O above that (PEEP = auto-PEEP +5). At each level of PEEP, airway pressures, flow and volume, hemodynamic variables (including right ventricular ejection fraction by thermodilution technique), and blood gas analyses were recorded. The mean auto-PEEP was 6.6 +/- 2.8 cm H2O and the total PEEP reached was 12.2 +/- 2.4 cm H2O. The degree of lung inflation induced by PEEP averaged 145 +/- 87 mL with PEEP = auto-PEEP and 495 +/- 133 mL with PEEP = auto-PEEP + 5. The PEEP = auto-PEEP caused a right ventricular end-diastolic pressure increase, but there was no other significant hemodynamic change. With PEEP = auto-PEEP + 5, there was a significant increase in intravascular pressures; this amount of PEEP reduced cardiac output (from 4.40 +/- 1.38 L/min at PEEP 0 to 4.13 +/- 1.48 L/min; p 10% in only five cases and this group of patients had significantly lower right ventricular volumes than the group with less cardiac output variation (right ventricular end-diastolic volume: 64 +/- 9 vs. 96 +/- 26 mL/m2; right ventricular end-systolic volume: 38 +/- 6 vs. 65 +/- 21 mL/m2; p < .05) without significant difference in the other variables that were measured. Neither right ventricular ejection fraction nor right ventricle volumes changed as PEEP increased, but there were marked interpatient

Taanduva Kruuda asemele astub ambitsioonikas Kusmin / Harry Tuul

Index Scriptorium Estoniae

Tuul, Harry

2006-01-01

Ilmunud ka: Delovõje Vedomosti 2. aug. lk. 7. Kalevi müügi- ja teenindusdirektor Kati Kusmin asub juhtimisest taanduva Oliver Kruuda asemele Kalevi tütarfirmade AS-i Kalev Chocolate Factory, AS-i Vilma ja AS-i Kalev Jõhvi Tootmine juhatuses. Lisa: Kati Kusmini CV. Vt. samas: Kruuda: taandun suuresti isiklikel põhjustel

Fourth Generation War: Paradigm for Change

Science.gov (United States)

2005-06-01

PARADIGM FOR CHANGE by Ghanshyam Singh Katoch June 2005 Thesis Advisor : Kalev Sepp Second Reader...Approved by: Kalev Sepp Thesis Advisor Douglas Borer Second Reader Gordon McCormick Chairman, Department of Defense...combination of all the resources of the government, not just the army. d. Economy of Effort A Robo -Soldier is a small, tracked, electrically powered vehicle

Clinical assessment of auto-positive end-expiratory pressure by diaphragmatic electrical activity during pressure support and neurally adjusted ventilatory assist.

Science.gov (United States)

Bellani, Giacomo; Coppadoro, Andrea; Patroniti, Nicolò; Turella, Marta; Arrigoni Marocco, Stefano; Grasselli, Giacomo; Mauri, Tommaso; Pesenti, Antonio

2014-09-01

Auto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP. In 10 patients with a clinical suspicion of auto-PEEP, the authors simultaneously recorded EAdi, airway, esophageal pressure, and flow during pressure support and NAVA, whereas external PEEP was increased from 2 to 14 cm H2O. Tracings were analyzed to measure apparent "dynamic" auto-PEEP (decrease in esophageal pressure to generate inspiratory flow), auto-EAdi (EAdi value at the onset of inspiratory flow), and IDEAdi (inspiratory delay between the onset of EAdi and the inspiratory flow). The pressure necessary to overcome auto-PEEP, auto-EAdi, and IDEAdi was significantly lower in NAVA as compared with pressure support ventilation, decreased with increase in external PEEP, although the effect of external PEEP was less pronounced in NAVA. Both auto-EAdi and IDEAdi were tightly correlated with auto-PEEP (r = 0.94 and r = 0.75, respectively). In the presence of auto-PEEP at lower external PEEP levels, NAVA was characterized by a characteristic shape of the airway pressure. In patients with auto-PEEP, NAVA, compared with pressure support ventilation, led to a decrease in the pressure necessary to overcome auto-PEEP, which could be reliably monitored by the electrical activity of the diaphragm before inspiratory flow onset (auto-EAdi).

Pragmaatika kui hea kunsti garant / Indrek Grigor

Index Scriptorium Estoniae

Grigor, Indrek, 1981-

2007-01-01

Tartu Kõrgema Kunstikooli diplomitöödest: Martti Poomi (S'Poom "Na'Miin") ja Asko Kikkuli (Iconcrash "My Sky") muusikavideotest, Kaisa Eiche teoreetilisest uurimusest "Kultuuritehase vajalikkus ja teostatavus Tartus", Carl-Christian Frey animafilmist "Pärastlõuna", Andrus Lauringsoni installatsioonist "Capaskoop", Berit Talpsepa robootilisest skulptuurist "Superheterodüünvastuvõtt", Eike Epliku installatiivsest skulptuurist "Ma saan aru, et ma ei ole orav", Anna-Stina Treumundi fotoinstallatsioonist "Vaikiv dialoog", Kalev Vapperi sotsiaalkollaazhist "Vapper Kalev lõpetab kooli"

Effects of positive end-expiratory pressure titration and recruitment maneuver on lung inflammation and hyperinflation in experimental acid aspiration-induced lung injury.

Science.gov (United States)

Ambrosio, Aline M; Luo, Rubin; Fantoni, Denise T; Gutierres, Claudia; Lu, Qin; Gu, Wen-Jie; Otsuki, Denise A; Malbouisson, Luiz M S; Auler, Jose O C; Rouby, Jean-Jacques

2012-12-01

In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. Forty-seven pigs were randomly allocated in seven groups: (1) controls spontaneously breathing; (2) without lung injury, PEEP 5 cm H2O; (3) without lung injury, PEEP titration; (4) without lung injury, PEEP titration + recruitment maneuver; (5) with lung injury, PEEP 5 cm H2O; (6) with lung injury, PEEP titration; and (7) with lung injury, PEEP titration + recruitment maneuver. Acute lung injury was induced by intratracheal instillation of hydrochloric acid. PEEP titration was performed by incremental and decremental PEEP from 5 to 20 cm H2O for optimizing arterial oxygenation. Three recruitment maneuvers (pressure of 40 cm H2O maintained for 20 s) were applied to the assigned groups at each PEEP level. Proportion of lung inflammation, hemorrhage, edema, and alveolar wall disruption were recorded on each histological field. Mean alveolar area was measured in the aerated lung regions. Acid aspiration increased mean alveolar area and produced alveolar wall disruption, lung edema, alveolar hemorrhage, and lung inflammation. PEEP titration significantly improved arterial oxygenation but simultaneously increased lung inflammation in juxta-diaphragmatic lung regions. Recruitment maneuver during PEEP titration did not induce additional increase in lung inflammation and alveolar hyperinflation. In a porcine model of acid aspiration-induced lung injury, PEEP titration aimed at optimizing arterial oxygenation, substantially increased lung inflammation. Recruitment maneuvers further improved arterial oxygenation without additional effects on inflammation and hyperinflation.

Alveolar Tidal recruitment/derecruitment and Overdistension During Four Levels of End-Expiratory Pressure with Protective Tidal Volume During Anesthesia in a Murine Lung-Healthy Model.

Science.gov (United States)

Soares, Joao Henrique Neves; Carvalho, Alysson Roncally; Bergamini, Bruno Curty; Gress, Maria Alice Kuster; Jandre, Frederico Caetano; Zin, Walter Araujo; Giannella-Neto, Antonio

2018-06-01

We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEP minErs ) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats. Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (P aw ), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) P aw (t) = E rs  × V(t) + R rs  × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) P aw (t) = (E 1  + E 2  × V(t)) × V(t) + (K 1  + K 2  × |F(t)|) × F(t) + PEEP, where E rs and R rs are respiratory system elastance and resistance, respectively; E 1 and E 2 × V are volume-independent and volume-dependent E rs , respectively; and K 1 and K 2  × F are flow-independent and flow-dependent R rs , respectively. Animals were ventilated for 1 h at PEEP 0 cmH 2 O (ZEEP); PEEP minErs ; 2 cmH 2 O above PEEP minErs (PEEP minErs+2 ); or 4 cmH 2 O above PEEP minErs (PEEP minErs+4 ). Alveolar tidal recruitment/derecruitment and overdistension were assessed by the index %E 2  = 100 × [(E 2  × V T )/(E 1  + |E 2 | × V T )], and alveolar stability by the slope of E rs (t). %E 2 varied between 0 and 30% at PEEP minErs in most respiratory cycles. Alveolar Tidal recruitment/derecruitment (%E 2   30) were predominant in the absence of PEEP and in PEEP levels higher than PEEP minErs , respectively. The slope of E rs (t) was different from zero in all groups besides PEEP minErs+4 . PEEP minErs presented the best compromise between alveolar tidal recruitment/derecruitment and overdistension, during 1 h of low-V T mechanical ventilation.

Setting individualized positive end-expiratory pressure level with a positive end-expiratory pressure decrement trial after a recruitment maneuver improves oxygenation and lung mechanics during one-lung ventilation.

Science.gov (United States)

Ferrando, Carlos; Mugarra, Ana; Gutierrez, Andrea; Carbonell, Jose Antonio; García, Marisa; Soro, Marina; Tusman, Gerardo; Belda, Francisco Javier

2014-03-01

We investigated whether individualized positive end-expiratory pressure (PEEP) improves oxygenation, ventilation, and lung mechanics during one-lung ventilation compared with standardized PEEP. Thirty patients undergoing thoracic surgery were randomly allocated to the study or control group. Both groups received an alveolar recruitment maneuver at the beginning and end of one-lung ventilation. After the alveolar recruitment maneuver, the control group had their lungs ventilated with a 5 cm·H2O PEEP, while the study group had their lungs ventilated with an individualized PEEP level determined by a PEEP decrement trial. Arterial blood samples, lung mechanics, and volumetric capnography were recorded at multiple timepoints throughout the procedure. The individualized PEEP values in study group were higher than the standardized PEEP values (10 ± 2 vs 5 cm·H2O; P decrement trial than with a standardized 5 cm·H2O of PEEP.

Neonatal Pneumothorax Pressures Surpass Higher Threshold in Lung Recruitment Maneuvers: An In Vivo Interventional Study.

Science.gov (United States)

González-Pizarro, Patricio; García-Fernández, Javier; Canfrán, Susana; Gilsanz, Fernando

2016-02-01

Causing pneumothorax is one of the main concerns of lung recruitment maneuvers in pediatric patients, especially newborns. Therefore, these maneuvers are not performed routinely during anesthesia. Our objective was to determine the pressures that cause pneumothorax in healthy newborns by a prospective experimental study of 10 newborn piglets (pneumothorax. Animals under anesthesia and bilateral chest tube catheterization were randomly allocated to 2 groups: one with PEEP and fixed inspiratory driving pressure of 15 cm H2O (PEEP group) and the second one with PEEP = 0 cm H2O and non-fixed inspiratory driving pressure (zero PEEP group). In both groups, the ventilation mode was pressure-controlled, and PIP was raised at 2-min intervals, with steps of 5 cm H2O until air leak was observed through the chest tubes. The PEEP group raised PIP through 5-cm H2O PEEP increments, and the zero PEEP group raised PIP through 5-cm H2O inspiratory driving pressure increments. Pneumothorax was observed with a PIP of 90.5 ± 15.7 cm H2O with no statistically significant differences between the PEEP group (92 ± 14.8 cm H2O) and the zero PEEP group (89 ± 18.2 cm H2O). The zero PEEP group had hypotension, with a PIP of 35 cm H2O; the PEEP group had hypotension, with a PIP of 60 cm H2O (P = .01). The zero PEEP group presented bradycardia, with PIP of 40 cm H2O; the PEEP group presented bradycardia, with PIP of 70 cm H2O (P = .002). Performing recruitment maneuvers in newborns without lung disease is a safe procedure in terms of pneumothorax. Pneumothorax does not seem to occur in the clinically relevant PIPs of pneumothorax PIP in poorly compliant lungs. Copyright © 2016 by Daedalus Enterprises.

Positive end expiratory pressure during one-lung ventilation: Selecting ideal patients and ventilator settings with the aim of improving arterial oxygenation

Directory of Open Access Journals (Sweden)

Hoftman Nir

2011-01-01

Full Text Available The efficacy of positive end-expiratory pressure (PEEP in treating intraoperative hypoxemia during one-lung ventilation (OLV remains in question given conflicting results of prior studies. This study aims to (1 evaluate the efficacy of PEEP during OLV, (2 assess the utility of preoperative predictors of response to PEEP, and (3 explore optimal intraoperative settings that would maximize the effects of PEEP on oxygenation. Forty-one thoracic surgery patients from a single tertiary care university center were prospectively enrolled in this observational study. After induction of general anesthesia, a double-lumen endotracheal tube was fiberoptically positioned and OLV initiated. Intraoperatively, PEEP = 5 and 10 cmH 2 O were sequentially applied to the ventilated lung during OLV. Arterial oxygenation, cardiovascular performance parameters, and proposed perioperative variables that could predict or enhance response to PEEP were analysed. T-test and c2 tests were utilized for continuous and categorical variables, respectively. Multivariate analyses were carried out using a classification tree model of binary recursive partitioning. PEEP improved arterial oxygenation by ≥20% in 29% of patients (n = 12 and failed to do so in 71% (n = 29; however, no cardiovascular impact was noted. Among the proposed clinical predictors, only intraoperative tidal volume per kilogram differed significantly between responders to PEEP and non-responders (mean 6.6 vs. 5.7 ml/kg, P = 0.013; no preoperative variable predicted response to PEEP. A multivariate analysis did not yield a clinically significant model for predicting PEEP responsiveness. PEEP improved oxygenation in a subset of patients; larger, although still protective tidal volumes favored a positive response to PEEP. No preoperative variables, however, could be identified as reliable predictors for PEEP responders.

Respiratory effects of low versus high tidal volume with or without positive end-expiratory pressure in anesthetized dogs with healthy lungs.

Science.gov (United States)

De Monte, Valentina; Bufalari, Antonello; Grasso, Salvatore; Ferrulli, Fabienne; Crovace, Alberto Maria; Lacitignola, Luca; Staffieri, Francesco

2018-05-01

OBJECTIVE To evaluate the impact of 2 tidal volumes (T V s) with or without positive end-expiratory pressure (PEEP) on lung mechanics, aeration, and gas exchange in healthy anesthetized dogs. ANIMALS 40 mixed-breed dogs with healthy lungs. PROCEDURES Anesthetized dogs were randomly assigned to 4 groups (n = 10/group) with different ventilatory settings: T V of 8 mL/kg and PEEP of 0 cm H 2 O (low T V group), T V of 8 mL/kg and PEEP of 5 cm H 2 O (low T V plus PEEP group), T V of 15 mL/kg and PEEP of 0 cm H 2 O (high T V group), or T V of 15 mL/kg and PEEP of 5 cm H 2 O (high T V plus PEEP group). Expired CO 2 and respiratory rate were titrated on the basis of a predetermined stepwise protocol. Gas exchange, respiratory mechanics, and pulmonary aeration were evaluated by means of CT 30 minutes after starting mechanical ventilation at the assigned setting. RESULTS Partial pressures of arterial and expired CO 2 were higher in the low T V and low T V plus PEEP groups than in the high T V and high T V plus PEEP groups. Peak and plateau airway pressures were higher in the PEEP group than in the other groups. Static lung compliance was higher in the high T V plus PEEP group than in the low T V group. Relative percentages of atelectatic and poorly aerated lung were lower in the high T V plus PEEP group than in the other groups. Oxygenation was similar among groups. CONCLUSIONS AND CLINICAL RELEVANCE Differences in T V and PEEP application during mechanical ventilation may affect respiratory function in anesthetized dogs with healthy lungs. Ventilation with a T V of 15 mL/kg and PEEP of 5 cm H 2 O significantly improved lung compliance and reduced the amount of atelectatic and poorly aerated lung.

Oliver Kruuda müüb salaja Kalevi ja Tere / Piret Reiljan, Kristina Traks, Virge Lahe

Index Scriptorium Estoniae

Reiljan, Piret, 1983-

2007-01-01

Ilmunud ka: Delovõje Vedomosti 26. sept. lk. 9. Suuromanikud Oliver Kruuda, Heino Priimägi ja Aare Annus otsustasid müüa kondiitritööstuse Kalev ja piimatööstuse Tere investeerimisettevõttele Alta Capital ning keskenduda meediale ja kinnisvarale. Vt. samas: Kalevi aktsionäre oli koosolekul vaid käputäis; Finantsinspektsiooni kommentaar; Alta Capital; Diagramm: Kalev AS-i tütarfirmade käibed. Kommenteerivad Alari Purju, Heldur Meerits ja Toomas Kivimägi

Impact of Different Ventilation Strategies on Driving Pressure, Mechanical Power, and Biological Markers During Open Abdominal Surgery in Rats.

Science.gov (United States)

Maia, Lígia de A; Samary, Cynthia S; Oliveira, Milena V; Santos, Cintia L; Huhle, Robert; Capelozzi, Vera L; Morales, Marcelo M; Schultz, Marcus J; Abreu, Marcelo G; Pelosi, Paolo; Silva, Pedro L; Rocco, Patricia Rieken Macedo

2017-10-01

Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery. Thirty-five Wistar rats were used, of which 28 were anesthetized, and a laparotomy was performed with standardized bowel manipulation. Postoperatively, animals (n = 7/group) were randomly assigned to 4 hours of ventilation with: (1) tidal volume (VT) = 7 mL/kg and positive end-expiratory pressure (PEEP) = 1 cm H2O without recruitment maneuvers (RMs) (low VT/low PEEP/RM-), mimicking the low-VT/low-PEEP strategy of PROVHILO; (2) VT = 7 mL/kg and PEEP = 3 cm H2O with RMs before laparotomy and hourly thereafter (low VT/moderate PEEP/4 RM+), mimicking the protective ventilation strategy of IMPROVE; (3) VT = 7 mL/kg and PEEP = 6 cm H2O with RMs only before laparotomy (low VT/high PEEP/1 RM+), mimicking the strategy used after intubation and before extubation in PROVHILO; or (4) VT = 14 mL/kg and PEEP = 1 cm H2O without RMs (high VT/low PEEP/RM-), mimicking conventional ventilation used in IMPROVE. Seven rats were not tracheotomized, operated, or mechanically ventilated, and constituted the healthy nonoperated and nonventilated controls. Low VT/moderate PEEP/4 RM+ and low VT/high PEEP/1 RM+, compared to low VT/low PEEP/RM- and high VT/low PEEP/RM-, resulted in lower ΔPRS (7.1 ± 0.8 and 10.2 ± 2.1 cm H2O vs 13.9 ± 0.9 and 16.9 ± 0.8 cm H2O, respectively; Pmechanical power (63 ± 7 and 79 ± 20 J/min vs 110 ± 10 and 120 ± 20 J/min, respectively; P = .007). Low VT/high PEEP/1 RM+ was associated with less alveolar collapse than low VT/low PEEP/RM- (P = .03). E-cadherin expression was higher in

OPTIMUM LEVEL OF POSITIVE END-EXPIRATORY PRESSURE IN ACUTE RESPIRATORY DISTRESS SYNDROME CAUSED BY INFLUENZA A(H1NI)PDM09: BALANCE BETWEEN MAXIMAL END-EXPIRATORY VOLUME AND MINIMAL ALVEOLAR OVERDISTENSION.

Science.gov (United States)

Yaroshetskiym A I; Protsenko, D N; Boytsov, P V; Chentsov, V B; Nistratov, S L; Kudlyakov, O N; Solov'ev, V V; Banova, Zh I; Shkuratova, N V; Rezenov, N A; Gel'fand, B R

2016-11-01

to determine optimum level ofpositive end-expiratory pressure (PEEP) according to balance between maxi- mal end-expiratory lung volume (EEL V)(more than predicted) and minimal decrease in exhaled carbon dioxide volume (VCO) and then to develop the algorithm of gas exchange correction based on prognostic values of EEL K; alveolar recruitability, PA/FiO2, static compliance (C,,,) and VCO2. 27 mechanically ventilatedpatients with acute respiratory distress syndrome (ARDS) caused by influenza A (HINJ)pdm09 in Moscow Municipal Clinics ICU's from January to March 2016 were included in the trial. At the beginning of the study patients had the following characteristic: duration offlu symptoms 5 (3-10) days, p.0/FiO2 120 (70-50) mmHg. SOFA 7 (5-9), body mass index 30.1 (26.4-33.8) kg/m², static compliance of respiratory system 35 (30-40) ml/mbar: Under sedation and paralysis we measured EELV, C VCO and end-tidal carbon dioxide concentration (EtCO) (for CO₂ measurements we fixed short-term values after 2 min after PEEP level change) at PEEP 8, 11,13,15,18, 20 mbar consequently, and incase of good recruitability, at 22 and 24 mbar. After analyses of obtained data we determined PEEP value in which increase in EELV was maximal (more than predicted) and depression of VCO₂ was less than 20%, change in mean blood pressure and heart rate were both less than 20% (measured at PEEP 8 mbar). After that we set thus determined level of PEEP and didn't change it for 5 days. Comparision of predicted and measured EELV revealed two typical points of alveloar recruiment: the first at PEEP 11-15 mbar, the second at PEEP 20-22 mbar. EELV measured at PEEP 18 mbar appeared to be higher than predicted at PEEP 8 mbar by 400 ml (approx.), which was the sign of alveolar recruitment-1536 (1020-1845) ml vs 1955 (1360-2320) ml, p=0,001, Friedman test). we didn't found significant changes of VCO₂ when increased PEEP in the range from 8 to 15 mbar (p>0.05, Friedman test). PEEP increase from 15 to

Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients

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Federico Franchi

2013-01-01

Full Text Available Purpose. The effects of mechanical ventilation (MV on speckle tracking echocardiography- (STE-derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP ventilation on 4-chamber longitudinal strain (LS analysis by STE. Methods. We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia. STE was performed at three times: (T1 PEEP = 5 cmH2O; (T2 PEEP = 10 cmH2O; and (T3 PEEP = 15 cmH2O. STE analysis was performed offline using a dedicated software (XStrain MyLab 70 Xvision, Esaote. Results. Left peak atrial-longitudinal strain (LS was significantly reduced from T1 to T2 and from T2 to T3 (. Right peak atrial-LS and right ventricular-LS showed a significant reduction only at T3 (. Left ventricular-LS did not change significantly during titration of PEEP. Cardiac chambers’ volumes showed a significant reduction at higher levels of PEEP (. Conclusions. We demonstrated for the first time that incremental PEEP affects myocardial strain values obtained with STE in intubated critically ill patients. Whenever performing STE in mechanically ventilated patients, care must be taken when PEEP is higher than 10 cmH2O to avoid misinterpreting data and making erroneous decisions.

Experimental intra-abdominal hypertension influences airway pressure limits for lung protective mechanical ventilation.

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Cortes-Puentes, Gustavo A; Cortes-Puentes, Luis A; Adams, Alexander B; Anderson, Christopher P; Marini, John J; Dries, David J

2013-06-01

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) may complicate monitoring of pulmonary mechanics owing to their impact on the respiratory system. However, recommendations for mechanical ventilation of patients with IAH/ACS and the interpretation of thoracoabdominal interactions remain unclear. Our study aimed to characterize the influence of elevated intra-abdominal pressure (IAP) and positive end-expiratory pressure (PEEP) on airway plateau pressure (PPLAT) and bladder pressure (PBLAD). Nine deeply anesthetized swine were mechanically ventilated via tracheostomy: volume-controlled mode at tidal volume (VT) of 10 mL/kg, frequency of 15, inspiratory-expiratory ratio of 1:2, and PEEP of 1 and 10 cm H2O (PEEP1 and PEEP10, respectively). A tracheostomy tube was placed in the peritoneal cavity, and IAP levels of 5, 10, 15, 20, and 25 mm Hg were applied, using a continuous positive airway pressure system. At each IAP level, PBLAD and airway pressure measurements were performed during both PEEP1 and PEEP10. PBLAD increased as experimental IAP rose (y = 0.83x + 0.5; R = 0.98; p < 0.001 at PEEP1). Minimal underestimation of IAP by PBLAD was observed (-2.5 ± 0.8 mm Hg at an IAP of 10-25 mm Hg). Applying PEEP10 did not significantly affect the correlation between experimental IAP and PBLAD. Approximately 50% of the PBLAD (in cm H2O) was reflected by changes in PPLAT, regardless of the PEEP level applied. Increasing IAP did not influence hemodynamics at any level of IAP generated. With minimal underestimation, PBLAD measurements closely correlated with experimentally regulated IAP, independent of the PEEP level applied. For each PEEP level applied, a constant proportion (approximately 50%) of measured PBLAD (in cm H2O) was reflected in PPLAT. A higher safety threshold for PPLAT should be considered in the setting of IAH/ACS as the clinician considers changes in VT. A strategy of reducing VT to cap PPLAT at widely recommended values may not be

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial.

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Bluth, T; Teichmann, R; Kiss, T; Bobek, I; Canet, J; Cinnella, G; De Baerdemaeker, L; Gregoretti, C; Hedenstierna, G; Hemmes, S N; Hiesmayr, M; Hollmann, M W; Jaber, S; Laffey, J G; Licker, M J; Markstaller, K; Matot, I; Müller, G; Mills, G H; Mulier, J P; Putensen, C; Rossaint, R; Schmitt, J; Senturk, M; Serpa Neto, A; Severgnini, P; Sprung, J; Vidal Melo, M F; Wrigge, H; Schultz, M J; Pelosi, P; Gama de Abreu, M

2017-04-28

Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m 2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH 2 O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH 2 O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016.

Cardiac output estimation using pulmonary mechanics in mechanically ventilated patients

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Hann Christopher E

2010-11-01

Full Text Available Abstract The application of positive end expiratory pressure (PEEP in mechanically ventilated (MV patients with acute respiratory distress syndrome (ARDS decreases cardiac output (CO. Accurate measurement of CO is highly invasive and is not ideal for all MV critically ill patients. However, the link between the PEEP used in MV, and CO provides an opportunity to assess CO via MV therapy and other existing measurements, creating a CO measure without further invasiveness. This paper examines combining models of diffusion resistance and lung mechanics, to help predict CO changes due to PEEP. The CO estimator uses an initial measurement of pulmonary shunt, and estimations of shunt changes due to PEEP to predict CO at different levels of PEEP. Inputs to the cardiac model are the PV loops from the ventilator, as well as the oxygen saturation values using known respiratory inspired oxygen content. The outputs are estimates of pulmonary shunt and CO changes due to changes in applied PEEP. Data from two published studies are used to assess and initially validate this model. The model shows the effect on oxygenation due to decreased CO and decreased shunt, resulting from increased PEEP. It concludes that there is a trade off on oxygenation parameters. More clinically importantly, the model also examines how the rate of CO drop with increased PEEP can be used as a method to determine optimal PEEP, which may be used to optimise MV therapy with respect to the gas exchange achieved, as well as accounting for the impact on the cardiovascular system and its management.

Intratidal recruitment/derecruitment persists at low and moderate positive end-expiratory pressure in paediatric patients.

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Wirth, Steffen; Artner, Lisa; Broß, Tobias; Lozano-Zahonero, Sara; Spaeth, Johannes; Schumann, Stefan

2016-12-01

In paediatric patients positive end-expiratory pressure (PEEP) is traditionally set lower than in adults. We investigated whether moderately higher PEEP improves respiratory mechanics and regional ventilation. Therefore, 40 children were mechanically ventilated with PEEP 2 and 5cmH 2 O. Volume-dependent compliance profiles were analysed as a measure of intratidal recruitment/derecruitment. Regional ventilation was assessed using electrical impedance tomography. Mean compliance was 17.9±9.9mLcmH 2 O -1 (PEEP 2cmH 2 O), and 19.0±10.9mLcmH 2 O -1 (PEEP 5 cmH 2 O, pventilation. In conclusion, mechanically ventilated paediatric patients undergo intratidal recruitment/derecruitment which occurs more prominently in younger than in older children. A PEEP of 5cmH 2 O does not fully prevent intratidal recruitment/derecruitment but homogenizes regional ventilation in comparison to 2cmH 2 O. Copyright © 2016 Elsevier B.V. All rights reserved.

Influence of tidal volume on ventilation inhomogeneity assessed by electrical impedance tomography during controlled mechanical ventilation

International Nuclear Information System (INIS)

Becher, T; Kott, M; Schädler, D; Vogt, B; Meinel, T; Weiler, N; Frerichs, I

2015-01-01

The global inhomogeneity (GI) index is a parameter of ventilation inhomogeneity that can be calculated from images of tidal ventilation distribution obtained by electrical impedance tomography (EIT). It has been suggested that the GI index may be useful for individual adjustment of positive end-expiratory pressure (PEEP) and for guidance of ventilator therapy. The aim of the present work was to assess the influence of tidal volume (V_T) on the GI index values. EIT data from 9 patients with acute respiratory distress syndrome ventilated with a low and a high V_T of 5   ±   1 (mean  ±  SD) and 9   ±   1 ml kg"−"1 predicted body weight at a high and a low level of PEEP (PEEP_h_i_g_h, PEEP_l_o_w) were analyzed. PEEP_h_i_g_h and PEEP_l_o_w were set 2 cmH_2O above and 5 cmH_2O below the lower inflection point of a quasi-static pressure volume loop, respectively. The lower inflection point was identified at 8.1   ±   1.4 (mean  ±  SD) cmH_2O, resulting in a PEEP_h_i_g_h of 10.1   ±   1.4 and a PEEP_l_o_w of 3.1   ±   1.4 cmH_2O. At PEEP_h_i_g_h, we found no significant trend in GI index with low V_T when compared to high V_T (0.49   ±   0.15 versus 0.44   ±   0.09, p = 0.13). At PEEP_l_o_w, we found a significantly higher GI index with low V_T compared to high V_T (0.66   ±   0.19 versus 0.59   ±   0.17, p = 0.01). When comparing the PEEP levels, we found a significantly lower GI index at PEEP_h_i_g_h both for high and low V_T. We conclude that high V_T may lead to a lower GI index, especially at low PEEP settings. This should be taken into account when using the GI index for individual adjustment of ventilator settings. (paper)

Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation.

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Shojaee, Majid; Sabzghabaei, Anita; Alimohammadi, Hossein; Derakhshanfar, Hojjat; Amini, Afshin; Esmailzadeh, Bahareh

2017-01-01

Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered. After gathering demographic data, patients underwent 0, 5, and 10 cmH 2 O PEEPs and the respective CVPs of the mentioned points were recorded. The relationship of CVP and PEEP in different cut points were measured using SPSS 21.0 statistical software. 60 patients with the mean age of 73.95 ± 11.58 years were evaluated (68.3% male). The most frequent cause of ICU admission was sepsis with 45.0%. 5 cmH 2 O increase in PEEP led to 2.47 ± 1.53 mean difference in CVP level. If the PEEP baseline is 0 at the time of 5 cmH 2 O increase, it leads to a higher raise in CVP compared to when the baseline is 5 cmH 2 O (2.47 ± 1.53 vs. 1.57 ± 1.07; p = 0.039). The relationship between CVP and 5 cmH 2 O (p = 0.279), and 10 cmH 2 O (p = 0.292) PEEP changes were not dependent on the baseline level of CVP. The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH 2 O increase in PEEP will be associated with about 2.5 cmH 2 O raise in CVP. When applying a 5 cmH 2 O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH 2 O (2.5 vs. 1.6). It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard.

Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation

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Majid Shojaee

2016-12-01

Full Text Available Introduction: Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. Methods: In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered. After gathering demographic data, patients underwent 0, 5, and 10 cmH2O PEEPs and the respective CVPs of the mentioned points were recorded. The relationship of CVP and PEEP in different cut points were measured using SPSS 21.0 statistical software. Results: 60 patients with the mean age of 73.95 ± 11.58 years were evaluated (68.3% male. The most frequent cause of ICU admission was sepsis with 45.0%. 5 cmH2O increase in PEEP led to 2.47 ± 1.53 mean difference in CVP level. If the PEEP baseline is 0 at the time of 5 cmH2O increase, it leads to a higher raise in CVP compared to when the baseline is 5 cmH2O (2.47 ± 1.53 vs. 1.57 ± 1.07; p = 0.039. The relationship between CVP and 5 cmH2O (p = 0.279, and 10 cmH2O (p = 0.292 PEEP changes were not dependent on the baseline level of CVP. Conclusion: The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH2O increase in PEEP will be associated with about 2.5 cmH2O raise in CVP. When applying a 5 cmH2O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH2O (2.5 vs. 1.6. It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard.

Influence of posture and positive end-tidal expiratory pressure (PEEP) on clearance of Tc99m-DTPA from the lungs

International Nuclear Information System (INIS)

Mason, G.R.; Maublant, J.; Sietsema, K.; Effros, R.M.; Mena, I.

1984-01-01

The clearance of Tc99m-DTPA aerosols from the lung has been used to detect and quantitate alterations in the permeability of the pulmonary epithelium. Clearance of the radionuclide is accelerated by both chronic and acute injuries to the lung and by smoking. Several laboratories have reported that Tc99m-DTPA clearance from upper lobes exceeded that from lower lobes in upright subjects. To investigate this phenomenon further the authors studied subjects with simultaneous anterior and posterior cameras in upright and supine positions. In the upright position, clearance from both the anterior and posterior upper regions of interest (ROI's) exceeded the lower regions (-1.64 +- .42 S.D. vs. -0.75 +- .41, anterior, p < .05, n=6), -1.04 +- .23 vs. -0.50 +- .36, posterior. All units = %/min. This difference was not observed in the supine subjects. Clearance from the anterior chest exceeded that from the posterior chest in the supine subjects (-1.28 +- .45 vs. -0.05 +- 1.08) and a small increase in radio-activity was observed in at least one ROI of 5 of 6 subjects from the posterior camera. An increase in activity is likely to be secondary to labeling of blood pool, which would have greatest affect where pulmonary blood volume is largest. Computer processing of the entire lung without observer bias in ROI placement showed similar effects of posture over non-peripheral ROI's. Five subjects breathed on PEEP to cause airspace distention, causing clearance to double. Both dependency and airspace distention appear to influence clearance of aerosolized DTPA, the latter may occur by stretching of epithelial pores

Combined Effects of Ventilation Mode and Positive End-Expiratory Pressure on Mechanics, Gas Exchange and the Epithelium in Mice with Acute Lung Injury

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Thammanomai, Apiradee; Hamakawa, Hiroshi; Bartolák-Suki, Erzsébet; Suki, Béla

2013-01-01

The accepted protocol to ventilate patients with acute lung injury is to use low tidal volume (VT) in combination with recruitment maneuvers or positive end-expiratory pressure (PEEP). However, an important aspect of mechanical ventilation has not been considered: the combined effects of PEEP and ventilation modes on the integrity of the epithelium. Additionally, it is implicitly assumed that the best PEEP-VT combination also protects the epithelium. We aimed to investigate the effects of ventilation mode and PEEP on respiratory mechanics, peak airway pressures and gas exchange as well as on lung surfactant and epithelial cell integrity in mice with acute lung injury. HCl-injured mice were ventilated at PEEPs of 3 and 6 cmH2O with conventional ventilation (CV), CV with intermittent large breaths (CVLB) to promote recruitment, and a new mode, variable ventilation, optimized for mice (VVN). Mechanics and gas exchange were measured during ventilation and surfactant protein (SP)-B, proSP-B and E-cadherin levels were determined from lavage and lung homogenate. PEEP had a significant effect on mechanics, gas exchange and the epithelium. The higher PEEP reduced lung collapse and improved mechanics and gas exchange but it also down regulated surfactant release and production and increased epithelial cell injury. While CVLB was better than CV, VVN outperformed CVLB in recruitment, reduced epithelial injury and, via a dynamic mechanotransduction, it also triggered increased release and production of surfactant. For long-term outcome, selection of optimal PEEP and ventilation mode may be based on balancing lung physiology with epithelial injury. PMID:23326543

Relationship of end-expiratory pressure, lung volume, and /sup 99m/Tc-DTPA clearance

International Nuclear Information System (INIS)

Cooper, J.A.; van der Zee, H.; Line, B.R.; Malik, A.B.

1987-01-01

We investigated the dose-response effect of positive end-expiratory pressure (PEEP) and increased lung volume on the pulmonary clearance rate of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). Clearance of lung radioactivity was expressed as percent decrease per minute. Base-line clearance was measured while anesthetized sheep (n = 20) were ventilated with 0 cmH 2 O end-expiratory pressure. Clearance was remeasured during ventilation at 2.5, 5, 10, 15, or 20 cmH 2 O PEEP. Further studies showed stepwise increases in functional residual capacity (FRC) (P less than 0.05) measured at 0, 2.5, 5, 10, 15, and 20 cmH 2 O PEEP. At 2.5 cmH 2 O PEEP, the clearance rate was not different from that at base line (P less than 0.05), although FRC was increased from base line. Clearance rate increased progressively with increasing PEEP at 5, 10, and 15 cmH 2 O (P less than 0.05). Between 15 and 20 cmH 2 O PEEP, clearance rate was again unchanged, despite an increase in FRC. The pulmonary clearance of aerosolized /sup 99m/Tc-DTPA shows a sigmoidal response to increasing FRC and PEEP, having both threshold and maximal effects. This relationship is most consistent with the hypothesis that alveolar epithelial permeability is increased by lung inflation

Respiratory System Mechanics During Low Versus High Positive End-Expiratory Pressure in Open Abdominal Surgery: A Substudy of PROVHILO Randomized Controlled Trial.

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D'Antini, Davide; Huhle, Robert; Herrmann, Jacob; Sulemanji, Demet S; Oto, Jun; Raimondo, Pasquale; Mirabella, Lucia; Hemmes, Sabrine N T; Schultz, Marcus J; Pelosi, Paolo; Kaczka, David W; Vidal Melo, Marcos Francisco; Gama de Abreu, Marcelo; Cinnella, Gilda

2018-01-01

In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D). To test our hypothesis, we used the volume-dependent elastance index %E2, a respiratory parameter that allows for noninvasive and radiation-free assessment of dominant overdistension and intratidal R/D. We compared the incidence of intratidal R/D, linear expansion, and overdistension by means of %E2 in a subset of the PROVHILO cohort. In 36 patients from 2 participating centers of the PROVHILO trial, we calculated respiratory system elastance (E), resistance (R), and %E2, a surrogate parameter for intratidal overdistension (%E2 > 30%) and R/D (%E2 mechanical ventilation with protective tidal volumes in patients undergoing open abdominal surgery, lung recruitment followed by PEEP of 12 cm H2O decreased the incidence of intratidal R/D and did not worsen overdistension, when compared to PEEP ≤2 cm H2O.

Kuidas kaasajal mõtestada rahvuslust? / ref. Urmi Reinde

Index Scriptorium Estoniae

2008-01-01

Keskerakonna noortekogu korraldatud konverentsil "Kuidas kaasajal mõtestada rahvuslust?" peetud ettekannete refereeringud: Edgar Savisaar, Leif Kalev, Ahto Lobjakas, Indrek Neivelt, Iris Pettai, Andrei Hvostov, Rein Ruutsoo

Variation of poorly ventilated lung units (silent spaces) measured by electrical impedance tomography to dynamically assess recruitment.

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Spadaro, Savino; Mauri, Tommaso; Böhm, Stephan H; Scaramuzzo, Gaetano; Turrini, Cecilia; Waldmann, Andreas D; Ragazzi, Riccardo; Pesenti, Antonio; Volta, Carlo Alberto

2018-01-31

Assessing alveolar recruitment at different positive end-expiratory pressure (PEEP) levels is a major clinical and research interest because protective ventilation implies opening the lung without inducing overdistention. The pressure-volume (P-V) curve is a validated method of assessing recruitment but reflects global characteristics, and changes at the regional level may remain undetected. The aim of the present study was to compare, in intubated patients with acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS), lung recruitment measured by P-V curve analysis, with dynamic changes in poorly ventilated units of the dorsal lung (dependent silent spaces [DSSs]) assessed by electrical impedance tomography (EIT). We hypothesized that DSSs might represent a dynamic bedside measure of recruitment. We carried out a prospective interventional study of 14 patients with AHRF and ARDS admitted to the intensive care unit undergoing mechanical ventilation. Each patient underwent an incremental/decremental PEEP trial that included five consecutive phases: PEEP 5 and 10 cmH 2 O, recruitment maneuver + PEEP 15 cmH 2 O, then PEEP 10 and 5 cmH 2 O again. We measured, at the end of each phase, recruitment from previous PEEP using the P-V curve method, and changes in DSS were continuously monitored by EIT. PEEP changes induced alveolar recruitment as assessed by the P-V curve method and changes in the amount of DSS (p Recruited volume measured by the P-V curves significantly correlated with the change in DSS (r s  = 0.734, p recruitment measured using the P-V curve technique. EIT might provide useful information to titrate personalized PEEP. ClinicalTrials.gov, NCT02907840 . Registered on 20 September 2016.

Application of dead space fraction to titrate optimal positive end-expiratory pressure in an ARDS swine model.

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Bian, Weishuai; Chen, Wei; Chao, Yangong; Wang, Lan; Li, Liming; Guan, Jian; Zang, Xuefeng; Zhen, Jie; Sheng, Bo; Zhu, Xi

2017-04-01

This study aimed to apply the dead space fraction [ratio of dead space to tidal volume (VD/VT)] to titrate the optimal positive end-expiratory pressure (PEEP) in a swine model of acute respiratory distress syndrome (ARDS). Twelve swine models of ARDS were constructed. A lung recruitment maneuver was then conducted and the PEEP was set at 20 cm H 2 O. The PEEP was reduced by 2 cm H 2 O every 10 min until 0 cm H 2 O was reached, and VD/VT was measured after each decrement step. VD/VT was measured using single-breath analysis of CO 2 , and calculated from arterial CO 2 partial pressure (PaCO 2 ) and mixed expired CO 2 (PeCO 2 ) using the following formula: VD/VT = (PaCO 2 - PeCO 2 )/PaCO 2 . The optimal PEEP was identified by the lowest VD/VT method. Respiration and hemodynamic parameters were recorded during the periods of pre-injury and injury, and at 4 and 2 cm H 2 O below and above the optimal PEEP (Po). The optimal PEEP in this study was found to be 13.25±1.36 cm H 2 O. During the Po period, VD/VT decreased to a lower value (0.44±0.08) compared with that during the injury period (0.68±0.10) (P<0.05), while the intrapulmonary shunt fraction reached its lowest value. In addition, a significant change of dynamic tidal respiratory compliance and oxygenation index was induced by PEEP titration. These results indicate that minimal VD/VT can be used for PEEP titration in ARDS.

Positive end-expiratory pressure improves gas exchange and pulmonary mechanics during partial liquid ventilation.

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Kirmse, M; Fujino, Y; Hess, D; Kacmarek, R M

1998-11-01

Partial liquid ventilation (PLV) with perflubron (PFB) has been proposed as an adjunct to the current therapies for the acute respiratory distress syndrome (ARDS). Because PFB has been also referred to as "liquid PEEP," distributing to the most gravity-dependent regions of the lung, less attention has been paid to the amount of applied positive end-expiratory pressure (PEEP). We hypothesized that higher PEEP levels than currently applied are needed to optimize gas exchange, and that the lower inflection point (LIP) of the pressure-volume curve could be used to estimate the amount of PEEP needed when the lung is filled with PFB. Lung injury was induced in 23 sheep by repeated lung lavage with warmed saline until the PaO2/FIO2 ratio fell below 150. Five sheep were used to investigate the change of the LIP when the lung was filled with PFB in increments of 5 ml/kg/body weight to a total of 30 ml/kg/body weight. To evaluate the impact of PEEP set at LIP +1 cm H2O we randomized an additional 15 sheep to three groups with different doses (7.5 ml, 15 ml, 30 ml/kg/body weight) of PFB. In random order a PEEP of 5 cm H2O or PEEP at LIP +1 cm H2O was applied. The LIP decreased with incremental filling of PFB to a minimum at 10 ml (p PFB shifts the LIP to the left, and that setting PEEP at LIP +1 cm H2O improves gas exchange at moderate to high doses of PFB.

Tartu meer õigustab küsitavat maatehingut / Laine Jänes ; interv. Andrus Karnau

Index Scriptorium Estoniae

Jänes, Laine, 1964-

2007-01-01

Tartu linnapea vastab küsimustele, mis on seotud Tartu linnavalitsuse maadevahetuse tehinguga Reformierakonnaga seotud ettevõtjate Verni Loodmaa, Kalev Kase ja Alar Kroodo firmaga Kvintett Kinnisvara

Open lung approach versus standard protective strategies: Effects on driving pressure and ventilatory efficiency during anesthesia - A pilot, randomized controlled trial.

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Ferrando, Carlos; Suarez-Sipmann, Fernando; Tusman, Gerardo; León, Irene; Romero, Esther; Gracia, Estefania; Mugarra, Ana; Arocas, Blanca; Pozo, Natividad; Soro, Marina; Belda, Francisco J

2017-01-01

Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia. Consecutive patients scheduled for major abdominal surgery were submitted to low-VT ventilation (6 ml·kg-1) and standard PEEP of 5 cmH2O (pre-RM, n = 36). After 30 min estabilization all patients received a RM and were randomly allocated to either continue with the same PEEP (RM-5 group, n = 18) or to an individualized open-lung PEEP (OL-PEEP) (Open Lung Approach, OLA group, n = 18) defined as the level resulting in maximal Cdyn during a decremental PEEP trial. We compared the effects on driving pressure and lung efficiency measured by volumetric capnography. OL-PEEP was found at 8±2 cmH2O. 36 patients were included in the final analysis. When compared with pre-RM, OLA resulted in a 22% increase in compliance and a 28% decrease in driving pressure when compared to pre-RM. These parameters did not improve in the RM-5. The trend of the DP was significantly different between the OLA and RM-5 groups (p = 0.002). VDalv/VTalv was significantly lower in the OLA group after the RM (p = 0.035). Lung recruitment applied during low-VT ventilation improves driving pressure and lung efficiency only when applied as an open-lung strategy with an individualized PEEP in patients without lung diseases undergoing major abdominal surgery. ClinicalTrials.gov NCT02798133.

Open lung approach versus standard protective strategies: Effects on driving pressure and ventilatory efficiency during anesthesia - A pilot, randomized controlled trial.

Directory of Open Access Journals (Sweden)

Carlos Ferrando

Full Text Available Low tidal volume (VT during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia.Consecutive patients scheduled for major abdominal surgery were submitted to low-VT ventilation (6 ml·kg-1 and standard PEEP of 5 cmH2O (pre-RM, n = 36. After 30 min estabilization all patients received a RM and were randomly allocated to either continue with the same PEEP (RM-5 group, n = 18 or to an individualized open-lung PEEP (OL-PEEP (Open Lung Approach, OLA group, n = 18 defined as the level resulting in maximal Cdyn during a decremental PEEP trial. We compared the effects on driving pressure and lung efficiency measured by volumetric capnography.OL-PEEP was found at 8±2 cmH2O. 36 patients were included in the final analysis. When compared with pre-RM, OLA resulted in a 22% increase in compliance and a 28% decrease in driving pressure when compared to pre-RM. These parameters did not improve in the RM-5. The trend of the DP was significantly different between the OLA and RM-5 groups (p = 0.002. VDalv/VTalv was significantly lower in the OLA group after the RM (p = 0.035.Lung recruitment applied during low-VT ventilation improves driving pressure and lung efficiency only when applied as an open-lung strategy with an individualized PEEP in patients without lung diseases undergoing major abdominal surgery.ClinicalTrials.gov NCT02798133.

Meeleolumaailma peegel / Jan Piotrowski

Index Scriptorium Estoniae

Piotrowski, Jan

2011-01-01

Inimkäitumise ettearvamatusest ja ennustatavusest, meeleoluanalüüsist. Kalev Leetaru (Illinoisi ülikool) revolutsioonide ennustamise võimalikkusest. Osama bin Ladeni tõenäolise asukoha avastamisest

Potential hazard of the Neopuff T-piece resuscitator in the absence of flow limitation.

LENUS (Irish Health Repository)

Hawkes, C P

2012-01-31

OBJECTIVE: (1) To assess peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP) and maximum pressure relief (P(max)) at different rates of gas flow, when the Neopuff had been set to function at 5 l\\/min. (2) To assess maximum PIP and PEEP at a flow rate of 10 l\\/min with a simulated air leak of 50%. DESIGN: 5 Neopuffs were set to a PIP of 20, PEEP of 5 and P(max) of 30 cm H(2)O at a gas flow of 5 l\\/min. PIP, PEEP and P(max) were recorded at flow rates of 10, 15 l\\/min and maximum flow. Maximum achievable pressures at 10 l\\/min gas flow, with a 50% air leak, were measured. RESULTS: At gas flow of 15 l\\/min, mean PEEP increased to 20 (95% CI 20 to 21), PIP to 28 (95% CI 28 to 29) and the P(max) to 40 cm H(2)O (95% CI 38 to 42). At maximum flow (85 l\\/min) a PEEP of 71 (95% CI 51 to 91) and PIP of 92 cm H(2)O (95% CI 69 to 115) were generated. At 10 l\\/min flow, with an air leak of 50%, the maximum PEEP and PIP were 21 (95% CI 19 to 23) and 69 cm H(2)O (95% CI 66 to 71). CONCLUSIONS: The maximum pressure relief valve is overridden by increasing the rate of gas flow and potentially harmful PIP and PEEP can be generated. Even in the presence of a 50% gas leak, more than adequate pressures can be provided at 10 l\\/min gas flow. We recommend the limitation of gas flow to a rate of 10 l\\/min as an added safety mechanism for this device.

Tidal Volume Delivery and Endotracheal Tube Leak during Cardiopulmonary Resuscitation in Intubated Newborn Piglets with Hypoxic Cardiac Arrest Exposed to Different Modes of Ventilatory Support.

Science.gov (United States)

Mendler, Marc R; Weber, Claudia; Hassan, Mohammad A; Huang, Li; Mayer, Benjamin; Hummler, Helmut D

2017-01-01

There are few data available on the interaction of inflations, chest compressions (CC), and delivery of tidal volumes in newborn infants undergoing resuscitation in the presence of endotracheal tube (ET) leaks. To determine the effects of different respiratory support strategies along with CC on changes in tidal volume and ET leaks in hypoxic newborn piglets with cardiac arrest. Asphyxiated newborn piglets, intubated with weight-adapted uncuffed ET, were randomized into three groups and resuscitated according to ILCOR 2010 guidelines: (1) T-piece resuscitator (TPR) group = peak inspiratory pressure (PIP)/positive end-expiratory pressure (PEEP) 25/5 cm H2O, rate 30/min, inflations interposed between CC (3:1 ratio); (2) self- inflating bag (SIB) group = PIP 25 cm H2O without PEEP, rate 30/min, inflations interposed between CC (3:1 ratio), and (3) ventilator group = PIP/PEEP of 25/5 cm H2O, rate 30/min. CC were applied with a rate of 120/min without synchrony to inflations. We observed a significant increase of leak (average increase 11.4%) when CC was added to respiratory support (p = 0.0001). Expired tidal volume was larger in the SIB group than in the two other modes which both applied PEEP. However, tidal volumes caused by CC only were larger in the two groups with PEEP than in the SIB group (without PEEP). There is interaction between lung inflations and CC affecting leak and delivery of tidal volume, which may be influenced by the mode/device used for respiratory support. Leak is larger in the presence of PEEP. However, CC cause additional tidal volume which is larger in the presence of PEEP. © 2016 S. Karger AG, Basel.

Prediction of high airway pressure using a non-linear autoregressive model of pulmonary mechanics.

Science.gov (United States)

Langdon, Ruby; Docherty, Paul D; Schranz, Christoph; Chase, J Geoffrey

2017-11-02

For mechanically ventilated patients with acute respiratory distress syndrome (ARDS), suboptimal PEEP levels can cause ventilator induced lung injury (VILI). In particular, high PEEP and high peak inspiratory pressures (PIP) can cause over distension of alveoli that is associated with VILI. However, PEEP must also be sufficient to maintain recruitment in ARDS lungs. A lung model that accurately and precisely predicts the outcome of an increase in PEEP may allow dangerous high PIP to be avoided, and reduce the incidence of VILI. Sixteen pressure-flow data sets were collected from nine mechanically ventilated ARDs patients that underwent one or more recruitment manoeuvres. A nonlinear autoregressive (NARX) model was identified on one or more adjacent PEEP steps, and extrapolated to predict PIP at 2, 4, and 6 cmH 2 O PEEP horizons. The analysis considered whether the predicted and measured PIP exceeded a threshold of 40 cmH 2 O. A direct comparison of the method was made using the first order model of pulmonary mechanics (FOM(I)). Additionally, a further, more clinically appropriate method for the FOM was tested, in which the FOM was trained on a single PEEP prior to prediction (FOM(II)). The NARX model exhibited very high sensitivity (> 0.96) in all cases, and a high specificity (> 0.88). While both FOM methods had a high specificity (> 0.96), the sensitivity was much lower, with a mean of 0.68 for FOM(I), and 0.82 for FOM(II). Clinically, false negatives are more harmful than false positives, as a high PIP may result in distension and VILI. Thus, the NARX model may be more effective than the FOM in allowing clinicians to reduce the risk of applying a PEEP that results in dangerously high airway pressures.

Coaching näitab töötajast hoolimist / Urve Vilk

Index Scriptorium Estoniae

Vilk, Urve

2012-01-01

Konverentsil "Arengukompass 2012: uue ajastu organisatsiooni arendusvahendid" esinenud juhtimiskoolitaja ja sertifitseeritud coach'i Ivar Lukki, Elioni tehnoloogiadirektori Kalev Reiljani ja superviisori Katrin Aava Tallinna Ülikoolist sõnavõttudest

Ehe seep Eesti moodi / Anneli Aasmäe

Index Scriptorium Estoniae

Aasmäe, Anneli, 1973-

2008-01-01

Produtsent Kristian Taska Kalev Spordis näidatav Venezuela seebiseriaali Eesti oludele mugandatud variant "Kalevi naised" : lavastaja Ingomar Vihman : osades Andrus Vaarik, Anne Reemann, Piret Kalda, Ken Saan jt.

Kaitsevägi pani printerikulu summaga kümme korda mööda

Index Scriptorium Estoniae

2014-01-01

Vastukaja 8. mail Eesti Päevalehes ilmunud artiklile "Tahad rahu, muretse printer". Artiklit kommenteerivad Kaitseväe logistikakeskuse ülem kolonelleitnant Kalev Koidumäe ja peaminister Taavi Rõivas

Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents pulmonary inflammation in patients without preexisting lung injury.

Science.gov (United States)

Wolthuis, Esther K; Choi, Goda; Dessing, Mark C; Bresser, Paul; Lutter, Rene; Dzoljic, Misa; van der Poll, Tom; Vroom, Margreeth B; Hollmann, Markus; Schultz, Marcus J

2008-01-01

Mechanical ventilation with high tidal volumes aggravates lung injury in patients with acute lung injury or acute respiratory distress syndrome. The authors sought to determine the effects of short-term mechanical ventilation on local inflammatory responses in patients without preexisting lung injury. Patients scheduled to undergo an elective surgical procedure (lasting > or = 5 h) were randomly assigned to mechanical ventilation with either higher tidal volumes of 12 ml/kg ideal body weight and no positive end-expiratory pressure (PEEP) or lower tidal volumes of 6 ml/kg and 10 cm H2O PEEP. After induction of anesthesia and 5 h thereafter, bronchoalveolar lavage fluid and/or blood was investigated for polymorphonuclear cell influx, changes in levels of inflammatory markers, and nucleosomes. Mechanical ventilation with lower tidal volumes and PEEP (n = 21) attenuated the increase of pulmonary levels of interleukin (IL)-8, myeloperoxidase, and elastase as seen with higher tidal volumes and no PEEP (n = 19). Only for myeloperoxidase, a difference was found between the two ventilation strategies after 5 h of mechanical ventilation (P volumes and PEEP may limit pulmonary inflammation in mechanically ventilated patients without preexisting lung injury. The specific contribution of both lower tidal volumes and PEEP on the protective effects of the lung should be further investigated.

Rae nahaalne skeem soosis lemmikuid / Nils Niitra

Index Scriptorium Estoniae

Niitra, Nils, 1975-

2007-01-01

Tartu linnavalitsuse maadevahetuse tehingust Reformierakonnaga seotud ettevõtjate Verni Loodmaa, Kalev Kase ja Alar Kroodo firmaga Kvintett Kinnisvara. Skeem: Maadevahetus linnavalitsuse tagatoas. Vt. samas: Lihtinimest ähvardab sundvõõrandamine

Jõulukaartide karm olelusvõitlus / Anneli Aasmäe

Index Scriptorium Estoniae

Aasmäe, Anneli, 1973-

2001-01-01

Eesti kunstnike kujundatud postkaartide valmistamise võimalused tänapäeva Eestis. Turu on vallutanud Hallmark Cards. Jõulukaartide saatmise kombest. Kommivabriku "Kalev" joonistusvõistluse võitis Margus Krassi kaart

PR, patriotism ja olupoliitika / Evi Arujärv

Index Scriptorium Estoniae

Arujärv, Evi, 1953-

2009-01-01

Proua Evelin Ilves kritiseeris kommivabriku Kalev toodangut transrasvade sisalduse pärast. Artikli autor analüüsib sellest hargnenud üldrahvalikku muljetevahetust kui väärtusmaailmade kokkupõrget

Kes on šõuilma tuntuimad (pool)eestlased? / Priit Pullerits

Index Scriptorium Estoniae

Pullerits, Priit, 1965-

2009-01-01

Eesti päritolu maailmas tuntud meelelahutusmaailmas osalejatest (Mena Suvari, Ornella Muti, Miliza Korjus, Kalev Mark Kostabi, Edmund Valtman, Erika Eleniak, Alar Kivilo, Ants Robert Kristian Luuk, Sonny Arahanga jt)

Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis.

Science.gov (United States)

Serpa Neto, Ary; Hemmes, Sabrine N T; Barbas, Carmen S V; Beiderlinden, Martin; Biehl, Michelle; Binnekade, Jan M; Canet, Jaume; Fernandez-Bustamante, Ana; Futier, Emmanuel; Gajic, Ognjen; Hedenstierna, Göran; Hollmann, Markus W; Jaber, Samir; Kozian, Alf; Licker, Marc; Lin, Wen-Qian; Maslow, Andrew D; Memtsoudis, Stavros G; Reis Miranda, Dinis; Moine, Pierre; Ng, Thomas; Paparella, Domenico; Putensen, Christian; Ranieri, Marco; Scavonetto, Federica; Schilling, Thomas; Schmid, Werner; Selmo, Gabriele; Severgnini, Paolo; Sprung, Juraj; Sundar, Sugantha; Talmor, Daniel; Treschan, Tanja; Unzueta, Carmen; Weingarten, Toby N; Wolthuis, Esther K; Wrigge, Hermann; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

2015-07-01

Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. Randomized controlled trials comparing protective ventilation (low VT with or without high levels of PEEP) and conventional ventilation (high VT with low PEEP) in patients undergoing general surgery. The primary outcome was development of PPC. Predefined prognostic factors were tested using multivariate logistic regression. Fifteen randomized controlled trials were included (2,127 patients). There were 97 cases of PPC in 1,118 patients (8.7%) assigned to protective ventilation and 148 cases in 1,009 patients (14.7%) assigned to conventional ventilation (adjusted relative risk, 0.64; 95% CI, 0.46 to 0.88; P ventilation with low VT and high PEEP levels and 63 cases in 525 patients (12%) assigned to ventilation with low VT and low PEEP levels (adjusted relative risk, 0.93; 95% CI, 0.64 to 1.37; P = 0.72). A dose-response relationship was found between the appearance of PPC and VT size (R2 = 0.39) but not between the appearance of PPC and PEEP level (R2 = 0.08). These data support the beneficial effects of ventilation with use of low VT in patients undergoing surgery. Further trials are necessary to define the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.

99% maaelu arengukavast võib saada heakskiidu / Heli Raamets

Index Scriptorium Estoniae

Raamets, Heli, 1975-

2007-01-01

Maaelu arengukava (MAK), mille alusel jagataks Eestile 14,5 miljardit krooni, ootab novembris Euroopa Liidu heakskiitu. Vt. samas: Euroopa Liidu maaelu arengukavadest; Kommenteerivad: Kalev Kreegipuu, Kaul Nurm, Silvia Lotman, Margus Timmo

Linnastumist hakatakse uurima kosmosest = Urbanisation will be studied from space / Piret Tali

Index Scriptorium Estoniae

Tali, Piret, 1972-

2014-01-01

Tartu Ülikooli füüsikud Kaupo Voormansik ja Karlis Zalite ning geograaf Kalev Koppel on loonud veebikaardi, mis aitab uurida linnastumist. Andmeid hakkab koguma Euroopa Komisjoni satelliit Sentinel-1

Prevention of pectus excavatum for children with spinal muscular atrophy type 1.

Science.gov (United States)

Bach, John R; Bianchi, Carlo

2003-10-01

To demonstrate the elimination of pectus excavatum and promotion of more normal lung growth and chest wall development by the use of high-span positive inspiratory pressure plus positive end-expiratory pressure (PIP+PEEP), patients with spinal muscular atrophy type 1 with paradoxical breathing were placed on high-span PIP+PEEP when sleeping from the point of diagnosis of spinal muscular atrophy. Although the appearance of pectus excavatum is ubiquitous in untreated infants with spinal muscular atrophy type 1, after institution of high-span PIP+PEEP, pectus resolves and lungs and chest walls grow more normally. High-span PIP+PEEP is indicated for all infants diagnosed with spinal muscular atrophy who demonstrate paradoxical breathing for the purpose of promoting more normal lung and chest development.

Bez kota mõsham razdolje / Jevgeni Kapov

Index Scriptorium Estoniae

Kapov, Jevgeni

2004-01-01

Sillamäe linnapea Ain Kiviorgi ja Vaivara vallavanema Veiko Luhalaidi kohtumisest Politseiameti peadirektori Robert Antropovi ja Ida politseiprefekti Kalev Prillopiga, kus arutati seoses politseireformiga Sillamäe regioonis tekkinud korrakaitse probleeme

Suurtootjad veavad Rae vallaga vägikaigast vee pärast / Villy Paimets

Index Scriptorium Estoniae

Paimets, Villy, 1972-

2007-01-01

Rae valla veefirma AS Elveso on vaidlustes magusavabriku Kalev, kaupluseketi Rimi suurköögi ja pelmeenitootjaga Uvic, süüdistades ettevõtteid heitvee liigses reostamises. Lisa: Taust; Uvicil pole probleeme

Ainult parim võidab / Martin Rünk

Index Scriptorium Estoniae

Rünk, Martin, 1982-

2011-01-01

Köler Prize 2011 nominentide (Dénes Kalev Farkas, Tõnis Saadoja, Timo Toots, Sigrid Viir, Jevgeni Zolotko) näitus Eesti Kaasaegse Kunsti Muuseumis 5. juunini. Esimest aastat väljaantavast autasust

Kruuda sai Kalevi eest ligi 33 miljonit eurot. Norra kontserni aruanne paljastab ostusumma / Kadrin Karner

Index Scriptorium Estoniae

Karner, Kadrin

2011-01-01

Orkla Group'i majandusaasta aruande kohaselt müüs Oliver Kruuda suurosalusega Luterma 2010. a. mais Kalev Chocolate Factory ja küpsisetootmise Norra taustaga toidukontsernile ligi 33 miljoni euro eest

Alessi : unistuste vabrik : 8 / Alberto Alessi

Index Scriptorium Estoniae

Alessi, Alberto

1999-01-01

Itaalia firma Alessi juures töötavate firmade Battista Piazza ja Tendentse toodangust. Alessandro Mendini projektist: 1992. a. anti standardne vaas kujundada sajale kunstnikule (nende hulgas Kalev Mark Kostabi). 30 illustratsiooni

Golõshom i publitshno / Sofja Bauer, Tiia Linnard

Index Scriptorium Estoniae

Bauer, Sofia, 1947-2001

1998-01-01

Ida-Virumaa kunstnike kevadnäitusest Jõhvis, kujundas Aleksandr Igonin. Tutvustatakse osalevaid kunstnikke : Kalev Prits (Pump), Aleksandr Igonin, Aira ja Mati Rautso, Ljudmila Maisurjan, Andres Malõgin, Irja Annus, Juri Horev jt.

Sustained Aeration of Infant Lungs (SAIL) trial: study protocol for a randomized controlled trial.

Science.gov (United States)

Foglia, Elizabeth E; Owen, Louise S; Thio, Marta; Ratcliffe, Sarah J; Lista, Gianluca; Te Pas, Arjan; Hummler, Helmut; Nadkarni, Vinay; Ades, Anne; Posencheg, Michael; Keszler, Martin; Davis, Peter; Kirpalani, Haresh

2015-03-15

Extremely preterm infants require assistance recruiting the lung to establish a functional residual capacity after birth. Sustained inflation (SI) combined with positive end expiratory pressure (PEEP) may be a superior method of aerating the lung compared with intermittent positive pressure ventilation (IPPV) with PEEP in extremely preterm infants. The Sustained Aeration of Infant Lungs (SAIL) trial was designed to study this question. This multisite prospective randomized controlled unblinded trial will recruit 600 infants of 23 to 26 weeks gestational age who require respiratory support at birth. Infants in both arms will be treated with PEEP 5 to 7 cm H2O throughout the resuscitation. The study intervention consists of performing an initial SI (20 cm H20 for 15 seconds) followed by a second SI (25 cm H2O for 15 seconds), and then PEEP with or without IPPV, as needed. The control group will be treated with initial IPPV with PEEP. The primary outcome is the combined endpoint of bronchopulmonary dysplasia or death at 36 weeks post-menstrual age. www.clinicaltrials.gov , Trial identifier NCT02139800 , Registered 13 May 2014.

Pulmonary lesion induced by low and high positive end-expiratory pressure levels during protective ventilation in experimental acute lung injury.

Science.gov (United States)

Pássaro, Caroline P; Silva, Pedro L; Rzezinski, Andréia F; Abrantes, Simone; Santiago, Viviane R; Nardelli, Liliane; Santos, Raquel S; Barbosa, Carolina M L; Morales, Marcelo M; Zin, Walter A; Amato, Marcelo B P; Capelozzi, Vera L; Pelosi, Paolo; Rocco, Patricia R M

2009-03-01

To investigate the effects of low and high levels of positive end-expiratory pressure (PEEP), without recruitment maneuvers, during lung protective ventilation in an experimental model of acute lung injury (ALI). Prospective, randomized, and controlled experimental study. University research laboratory. Wistar rats were randomly assigned to control (C) [saline (0.1 mL), intraperitoneally] and ALI [paraquat (15 mg/kg), intraperitoneally] groups. After 24 hours, each group was further randomized into four groups (six rats each) at different PEEP levels = 1.5, 3, 4.5, or 6 cm H2O and ventilated with a constant tidal volume (6 mL/kg) and open thorax. Lung mechanics [static elastance (Est, L) and viscoelastic pressure (DeltaP2, L)] and arterial blood gases were measured before (Pre) and at the end of 1-hour mechanical ventilation (Post). Pulmonary histology (light and electron microscopy) and type III procollagen (PCIII) messenger RNA (mRNA) expression were measured after 1 hour of mechanical ventilation. In ALI group, low and high PEEP levels induced a greater percentage of increase in Est, L (44% and 50%) and DeltaP2, L (56% and 36%) in Post values related to Pre. Low PEEP yielded alveolar collapse whereas high PEEP caused overdistension and atelectasis, with both levels worsening oxygenation and increasing PCIII mRNA expression. In the present nonrecruited ALI model, protective mechanical ventilation with lower and higher PEEP levels than required for better oxygenation increased Est, L and DeltaP2, L, the amount of atelectasis, and PCIII mRNA expression. PEEP selection titrated for a minimum elastance and maximum oxygenation may prevent lung injury while deviation from these settings may be harmful.

Differing responses in right and left ventricular filling, loading and volumes during positive end-expiratory pressure

International Nuclear Information System (INIS)

Schulman, D.S.; Biondi, J.W.; Matthay, R.A.; Zaret, B.L.; Soufer, R.

1989-01-01

Using a combined hemodynamic and radionuclide technique, 20 patients with varied ventricular function were evaluated during positive end-expiratory pressure (PEEP) application. Left ventricular (LV) and right ventricular (RV) ejection fractions and cardiac output were measured, and ventricular volumes were derived. Seven patients (group 1) who had an increase in LV end-diastolic volume with PEEP and 13 patients (group 2) who had the more typical response, a decrease in LV end-diastolic volume with PEEP, were identified. Compared with group 2, group 1 patients had a higher incidence of coronary artery disease (5 of 7 vs 1 of 13, p less than 0.005) and lower cardiac output (3.9 +/- 1.6 vs 9.1 +/- 3.2 liters/min, p less than 0.005), LV ejection fraction (27 +/- 13 vs 51 +/- 21%, p less than 0.05), RV ejection fraction (15 +/- 6 vs 32 +/- 8%, p less than 0.005) and peak filling rate (1.32 +/- 0.43 vs 3.51 +/- 1.70 end-diastolic volumes/s, p less than 0.05). LV and RV volumes increased and peak filling rate decreased with PEEP in group 1, whereas in group 2 LV volume decreased and RV volume and peak filling rate remained unchanged. Using stepwise regression analysis, the change in LV volume with PEEP was related directly to baseline systemic vascular resistance and inversely to baseline blood pressure. Similarly, the change in peak filling rate with PEEP was inversely related to the change in RV end-diastolic volume. Thus, the hemodynamic response to PEEP is heterogeneous and may be related to LV ischemia

Kaasaegse kunsti muuseum suurendab panuseid - Köler Prize / Hanno Soans

Index Scriptorium Estoniae

Soans, Hanno, 1974-

2011-01-01

Eesti Kaasaegse Kunsti Muuseumi loodud kaasaegse kunsti preemiast. 6. juunini EKKM-is avatud Köler Prize 2011 nominentide - Dénes Kalev Farkas, Tõnis Saadoja, Timo Toots, Sigrid Viir, Jevgeni Zolotko - näitusest

Köler värskele kunstile / Anders Härm ; intervjueerinud Kadri Karro

Index Scriptorium Estoniae

Härm, Anders, 1977-

2011-01-01

Köler Prize 2011 nominentide (Dénes Kalev Farkas, Tõnis Saadoja, Timo Toots, Sigrid Viir, Jevgeni Zolotko) näitus Eesti Kaasaegse Kunsti Muuseumis 30. aprillist 5. juunini. Preemia asutamisest ja nominentide valikust

Keskerakond võitles töörahva õiguste eest kella kaheni öösel / Andrus Karnau, Artur Sadovski

Index Scriptorium Estoniae

Karnau, Andrus

2008-01-01

Töölepinguseaduse eelnõu teisest lugemisest riigikogus. Lisatud: töölepinguseaduse uuendused ; Kaire Uuseni intervjuu Kalev Chocolate Factory personalijuhi Kärt Kirsoga: Ettevõtjad aimavad töövaidluste arvu kasvu

KIK pidas sünnipäeva / Endrik Tõnsberg

Index Scriptorium Estoniae

Tõnsberg, Endrik

2005-01-01

11. mail 2005. a. andsid Keskkonnainvesteeringute Keskuse viienda sünnipäeva puhul ajakirjanikele pressikonverentsi KIK-i nõukogu esimees, keskkonnaminister Villu Reiljan, KIK-i juhataja Kalev Aun ja programmijuht Heiko Põdersalu

Kaks mõrva ühes mesilasperes ehk laibarida ei tule / Lauri Tabur ; interv. Enno Tammer

Index Scriptorium Estoniae

Tabur, Lauri, 1974-

2005-01-01

Keskkriminaalpolitsei ülem vastab küsimustele, mis puudutavad Tallinna koolitüdruku Veronika Dari, eestikeelse allilma väidetava liidri Kalev Kure ning ärimees Kauri Koppeli mõrvu Tallinnas. Lisa: Kiirarvamus

Comparison of lung protective ventilation strategies in a rabbit model of acute lung injury.

Science.gov (United States)

Rotta, A T; Gunnarsson, B; Fuhrman, B P; Hernan, L J; Steinhorn, D M

2001-11-01

To determine the impact of different protective and nonprotective mechanical ventilation strategies on the degree of pulmonary inflammation, oxidative damage, and hemodynamic stability in a saline lavage model of acute lung injury. A prospective, randomized, controlled, in vivo animal laboratory study. Animal research facility of a health sciences university. Forty-six New Zealand White rabbits. Mature rabbits were instrumented with a tracheostomy and vascular catheters. Lavage-injured rabbits were randomized to receive conventional ventilation with either a) low peak end-expiratory pressure (PEEP; tidal volume of 10 mL/kg, PEEP of 2 cm H2O); b) high PEEP (tidal volume of 10 mL/kg, PEEP of 10 cm H2O); c) low tidal volume with PEEP above Pflex (open lung strategy, tidal volume of 6 mL/kg, PEEP set 2 cm H2O > Pflex); or d) high-frequency oscillatory ventilation. Animals were ventilated for 4 hrs. Lung lavage fluid and tissue samples were obtained immediately after animals were killed. Lung lavage fluid was assayed for measurements of total protein, elastase activity, tumor necrosis factor-alpha, and malondialdehyde. Lung tissue homogenates were assayed for measurements of myeloperoxidase activity and malondialdehyde. The need for inotropic support was recorded. Animals that received a lung protective strategy (open lung or high-frequency oscillatory ventilation) exhibited more favorable oxygenation and lung mechanics compared with the low PEEP and high PEEP groups. Animals ventilated by a lung protective strategy also showed attenuation of inflammation (reduced tracheal fluid protein, tracheal fluid elastase, tracheal fluid tumor necrosis factor-alpha, and pulmonary leukostasis). Animals treated with high-frequency oscillatory ventilation had attenuated oxidative injury to the lung and greater hemodynamic stability compared with the other experimental groups. Both lung protective strategies were associated with improved oxygenation, attenuated inflammation, and

Koda = Koda / Ülar Mark, Kariina Kristiina Kaufmann, Kadri Tonto ; kommenteerinud Katrin Koov

Index Scriptorium Estoniae

Mark, Ülar, 1968-

2016-01-01

Minimalistliku vormiga eramu KODA Tallinnas, Järvekalda tee 33. Autorid Ülar Mark, Taavi Jakobson, Hannes Tamjärv, Kalev Ramjalg, Marek Strandberg. Arhitektid Ülar Mark, Kariina Kristiina Kaufmann, Kadri Tonto, Hannes Praks

Tootest olulisemaks saab ärimudel. Kandiline arbuus tavalisest 30 korda kallim / Ain Alvela ; kommenteerinud Janek Kalvi

Index Scriptorium Estoniae

Alvela, Ain, 1967-

2011-01-01

Eesti Arengufondi juhatuse esimehe Ott Pärna, ASi Kalev Chocolate Factory juhataja Kaido Kaare ja ASi Balsnack International Holding juhatuse esimehe Elmar Rusingu ettekannetest toiduainetööstuse aastakonverentsil "Uue tõusu ootuses". Graafik

Leil on kõva! : dokumentaalne lugemisdraama neljas pildis. Volüüm 2 / Madis Jürgen

Index Scriptorium Estoniae

Jürgen, Madis, 1962-

1999-01-01

Miks tahavad poliitikud Sauna tänavale teatrit? Tegelased: Krista Siilats, Jaan Tamm, Signe Kivi, Jüri Kuuskemaa, Margus Allikmaa, Krista Kodres, Kalev Kallo, Tiina Mägi, Silvi Lindma-Pihlak, Eino Baskin, Mart Laar.

Maksuameti eksjuht ostis 66000kroonise Picasso

Index Scriptorium Estoniae

1999-01-01

Modernistliku kunsti klassikute näituselt galeriis "Vaal" osteti kaks Picasso keraamilist teost: "Curly Hair Face" omandas 66000 krooni eest Kalev Järvelill ja "Man's Face" 33000 krooni eest ERA-Panga pankrotihaldur Veli Kraavi.

Mütsiga lüües : kuidas väärikalt vananeda? / Imbi Jeletsky

Index Scriptorium Estoniae

Jeletsky, Imbi

2007-01-01

Vt. ka Kesknädal 21. nov., lk. 12. ETV saates "Vabariigi kodanikud" arutleti vananemise teemal. Stuudios olid kirjanik Maimu Berg, rahvastikuteadlane Kalev Katus ja kunstnik Heinz Valk, saatejuht oli Aarne Rannamäe

Uus omanik liidab Kalevi vabriku Poola tehasega / Andrus Karnau

Index Scriptorium Estoniae

Karnau, Andrus

2007-01-01

Kommivabriku Kalev ja piimatööstuse Tere uus omanik Indrek Rahumaa kavatseb ettevõtted liita Poola kommivabrikuga Mieszko ja Läti piimakombinaadiga Piensaimnieks, mille on ostnud Rahumaa enamusosalusega investeerimisfirma Alta Capital Partners. Lisa: CV

Kalevi uus omanik tahab ettevõtte eksportima panna / Raigo Neudorf ; kommenteerinud Kuldar Leis, Kati Kusmin, Vjatšeslav Leedo

Index Scriptorium Estoniae

Neudorf, Raigo

2010-01-01

AS-i Kalev Chocolate Factory osta sooviv Orkla kontrerni esindajate kinnitusel hakatakse edaspidi toodangut eksportima nii Balti- kui Põhjamaadesse. Enne varade üleminekut uuele omanikule tuleb ära oodata Kalevi aktsiate aresti alt vabanemine. Diagramm

Injurious mechanical ventilation in the normal lung causes a progressive pathologic change in dynamic alveolar mechanics.

Science.gov (United States)

Pavone, Lucio A; Albert, Scott; Carney, David; Gatto, Louis A; Halter, Jeffrey M; Nieman, Gary F

2007-01-01

Acute respiratory distress syndrome causes a heterogeneous lung injury, and without protective mechanical ventilation a secondary ventilator-induced lung injury can occur. To ventilate noncompliant lung regions, high inflation pressures are required to 'pop open' the injured alveoli. The temporal impact, however, of these elevated pressures on normal alveolar mechanics (that is, the dynamic change in alveolar size and shape during ventilation) is unknown. In the present study we found that ventilating the normal lung with high peak pressure (45 cmH(2)0) and low positive end-expiratory pressure (PEEP of 3 cmH(2)O) did not initially result in altered alveolar mechanics, but alveolar instability developed over time. Anesthetized rats underwent tracheostomy, were placed on pressure control ventilation, and underwent sternotomy. Rats were then assigned to one of three ventilation strategies: control group (n = 3, P control = 14 cmH(2)O, PEEP = 3 cmH(2)O), high pressure/low PEEP group (n = 6, P control = 45 cmH(2)O, PEEP = 3 cmH(2)O), and high pressure/high PEEP group (n = 5, P control = 45 cmH(2)O, PEEP = 10 cmH(2)O). In vivo microscopic footage of subpleural alveolar stability (that is, recruitment/derecruitment) was taken at baseline and than every 15 minutes for 90 minutes following ventilator adjustments. Alveolar recruitment/derecruitment was determined by measuring the area of individual alveoli at peak inspiration (I) and end expiration (E) by computer image analysis. Alveolar recruitment/derecruitment was quantified by the percentage change in alveolar area during tidal ventilation (%I - E Delta). Alveoli were stable in the control group for the entire experiment (low %I - E Delta). Alveoli in the high pressure/low PEEP group were initially stable (low %I - E Delta), but with time alveolar recruitment/derecruitment developed. The development of alveolar instability in the high pressure/low PEEP group was associated with histologic lung injury. A large change in

Positive end-expiratory pressure increases pulmonary clearance of inhaled 99mTc-DTPA in nonsmokers but not in healthy smokers

International Nuclear Information System (INIS)

Nolop, K.B.; Braude, S.; Royston, D.; Maxwell, D.L.; Hughes, J.M.B.

1987-01-01

Positive end-expiratory pressure (PEEP) is widely used in the treatment of severe pulmonary oedema, although its effects on the clearance of water and small solutes from alveolus to blood are not well characterized. We studied the effect of the application of 10 cmH 2 O of PEEP on the flux of inhaled 99 mTc-diethylene-triamine-penta-acetic acid (DTPA) from lung to blood in six healthy smoking and six nonsmoking subjects. The rate of flux was corrected for possible changes in pulmonary blood volume during PEEP by use of an intravenous injection of 99m Tc-DTPA. The baseline clearance rate (K,%.min -1 ) for nonsmokers was 1.48±0.12 (mean±SE) and increased to 2.40±0.29 during PEEP (p<0.05). In contrast, the mean clearance rate for smokers was 3.26±0.82 at baseline and 3.03±0.82 during PEEP (p=NS). The application of positive end-expiratory pressure appears to increase alveolar solute flux in nonsmokers but not in smokers, suggesting that the pathway for solute clearance in smokers is governed by different rate-limiting steps to those of nonsmokers

Edgari paralleelne ühiskond / Argo Ideon

Index Scriptorium Estoniae

Ideon, Argo, 1966-

2008-01-01

Autor leiab, et Keskerakonna esimees Edgar Savisaar on rajamas omaenda suveräänset maailma, ning toob selle kohta näiteid: vapimärgid vs teenetemärgid, vabaduskell vs vabadussammas, Kalev Sport vs ETV

Brest-Litovski rahuleping ja Vladimir Putin / Küllo Arjakas

Index Scriptorium Estoniae

Arjakas, Küllo, 1959-

2005-01-01

Autor selgitab Venemaa presidendi Vladimir Putini möödalaskmisi ajalooküsimuste käsitlemisel 10. mail Moskvas toimunud pressikonverentsil. Bresti rahukõneluste ja rahulepingu ajaloost. Vt. samas: Kalev Vilgats. Vene presidendi must-valge maailm

Salt Lake Cityst Torinoni / Olev Remsu

Index Scriptorium Estoniae

Remsu, Olev, 1947-

2006-01-01

Dokumentaalfilm Eesti suusameeskonna valmistumisest Torino olümpiamängudeks "Tiim" : idee autorid Peep Puks, Hans Roosipuu : režissöör Peep Puks : F-Seitse 2006. Esilinastus toimus 26. mail Otepääl, ETVs 31. mail

Lenz, Eestis unustatud geenius / Riina Mägi

Index Scriptorium Estoniae

Mägi, Riina, 1957-

2001-01-01

Tartus toimunud rahvusvahelise Lenzi-konverentsi (Jakob Michael Reinhold Lenz) publik nägi väljasõidul Põltsamaale Lenzi kirjutatud näidendit "Haavatud peigmees", mis esitati Tartu üliõpilasteatri poolt Põltsamaa lossihoovis. Lav. Kalev Kudu

Evaluation of lung recruitment maneuvers in acute respiratory distress syndrome using computer simulation.

Science.gov (United States)

Das, Anup; Cole, Oana; Chikhani, Marc; Wang, Wenfei; Ali, Tayyba; Haque, Mainul; Bates, Declan G; Hardman, Jonathan G

2015-01-12

Direct comparison of the relative efficacy of different recruitment maneuvers (RMs) for patients with acute respiratory distress syndrome (ARDS) via clinical trials is difficult, due to the heterogeneity of patient populations and disease states, as well as a variety of practical issues. There is also significant uncertainty regarding the minimum values of positive end-expiratory pressure (PEEP) required to ensure maintenance of effective lung recruitment using RMs. We used patient-specific computational simulation to analyze how three different RMs act to improve physiological responses, and investigate how different levels of PEEP contribute to maintaining effective lung recruitment. We conducted experiments on five 'virtual' ARDS patients using a computational simulator that reproduces static and dynamic features of a multivariable clinical dataset on the responses of individual ARDS patients to a range of ventilator inputs. Three recruitment maneuvers (sustained inflation (SI), maximal recruitment strategy (MRS) followed by a titrated PEEP, and prolonged recruitment maneuver (PRM)) were implemented and evaluated for a range of different pressure settings. All maneuvers demonstrated improvements in gas exchange, but the extent and duration of improvement varied significantly, as did the observed mechanism of operation. Maintaining adequate post-RM levels of PEEP was seen to be crucial in avoiding cliff-edge type re-collapse of alveolar units for all maneuvers. For all five patients, the MRS exhibited the most prolonged improvement in oxygenation, and we found that a PEEP setting of 35 cm H2O with a fixed driving pressure of 15 cm H2O (above PEEP) was sufficient to achieve 95% recruitment. Subsequently, we found that PEEP titrated to a value of 16 cm H2O was able to maintain 95% recruitment in all five patients. There appears to be significant scope for reducing the peak levels of PEEP originally specified in the MRS and hence to avoid exposing the lung to

Capital structure optimization on the example of Estonian industrial companies : the case of three constraints / Roman Zahharov

Index Scriptorium Estoniae

Zahharov, Roman

2003-01-01

Kapitali struktuuri optimeerimisest. Analüüsi aluseks on võetud Eesti tööstusettevõtete (Baltika, Estiko, Kalev, Klementi, Norma, Saku Õlletehas, Rakvere Lihakombinaat, Viisnurk) 1996-2001 aastate finantsaruanded. Lisad lk. 238-241. Tabelid. Diagramm

Kõige eest siin elus tuleb maksta / Piret Hartman

Index Scriptorium Estoniae

Hartman, Piret

2006-01-01

ERL-i fraktsiooni nõunik käsitleb rahvastikuteadlase Kalev Katuse loengut Eesti rahvastikuarengust Euroopa kontekstis. Rahvastiku juurdekasv tuleb seada kõigis valdkondades esmatähtsaks, vaja on terviklikku toetussüsteemi kuni lapse täiskasvanuks saamiseni

Pharmacologic Interventions to Improve Splanchnic Oxygenation During Ventilation with Positive End-Expiratory Pressure

NARCIS (Netherlands)

Fournell, A.; Scheeren, T. W. L.; Picker, O.; Schwarte, L. A.; Wolf, M; Bucher, HU; Rudin, M; VanHuffel, S; Wolf, U; Bruley, DF; Harrison, DK

2012-01-01

Mechanical ventilation with positive end-expiratory pressure (PEEP) is an indispensable tool in the management of respiratory failure to preserve or improve lung function and systemic oxygenation. However, PEEP per se may also, as has been shown in experimental animals, impair regional

Ma olen Turist, ma elan siin / Mait Väljas

Index Scriptorium Estoniae

Väljas, Mait

2006-01-01

Endise valuutapoe, praeguse klubi "Parlament" lammutamisplaanist Tallinnas Tartu mnt. 17. Arhitektid Peep Jänes ja Henno Sepmann, sisearhitekt Toivo Gans, sisekujundaja Aulo Padar. Ehitamisel osalesid ka soome arhitektid Kalle-Heiki Narinen ja Tapio Hänninen. Kommentaar Peep Jäneselt ja Aulo Padarilt

Low tidal volume and high positive end-expiratory pressure mechanical ventilation results in increased inflammation and ventilator-associated lung injury in normal lungs.

Science.gov (United States)

Hong, Caron M; Xu, Da-Zhong; Lu, Qi; Cheng, Yunhui; Pisarenko, Vadim; Doucet, Danielle; Brown, Margaret; Aisner, Seena; Zhang, Chunxiang; Deitch, Edwin A; Delphin, Ellise

2010-06-01

Protective mechanical ventilation with low tidal volume (Vt) and low plateau pressure reduces mortality and decreases the length of mechanical ventilation in patients with acute respiratory distress syndrome. Mechanical ventilation that will protect normal lungs during major surgical procedures of long duration may improve postoperative outcomes. We performed an animal study comparing 3 ventilation strategies used in the operating room in normal lungs. We compared the effects on pulmonary mechanics, inflammatory mediators, and lung tissue injury. Female pigs were randomized into 3 groups. Group H-Vt/3 (n = 6) was ventilated with a Vt of 15 mL/kg predicted body weight (PBW)/positive end-expiratory pressure (PEEP) of 3 cm H(2)O, group L-Vt/3 (n = 6) with a Vt of 6 mL/kg PBW/PEEP of 3 cm H(2)O, and group L-Vt/10 (n = 6) with a Vt of 6 mL/kg PBW/PEEP of 10 cm H(2)O, for 8 hours. Hemodynamics, airway mechanics, arterial blood gases, and inflammatory markers were monitored. Bronchoalveolar lavage (BAL) was analyzed for inflammatory markers and protein concentration. The right lower lobe was assayed for mRNA of specific cytokines. The right lower lobe and right upper lobe were evaluated histologically. In contrast to groups H-Vt/3 and L-Vt/3, group L-Vt/10 exhibited a 6-fold increase in inflammatory mediators in BAL (P ventilation with high PEEP resulted in increased production of inflammatory markers. Low PEEP resulted in lower levels of inflammatory markers. High Vt/low PEEP resulted in less histologic lung injury.

Koda = Koda / Kadri Tonto

Index Scriptorium Estoniae

Tonto, Kadri

2016-01-01

Minimalistliku vormiga eramu KODA. Kontseptsiooni autorid Ülar Mark, Taavi Jakobson, Hannes Tamjärv, Kalev Ramjalg, Marek Strandberg; arhitektid Ülar Mark, Kariina Kristiina Kaufmann, Kadri Tonto, Hannes Praks. Eesti Arhitektide Liidu preemia "Väike 2013-2015" laureaat

Ettevaatust! Sünnib Eesti esimene päris telenovela / Mart Niineste

Index Scriptorium Estoniae

Niineste, Mart, 1983-

2008-01-01

Produtsent Kristian Taska filmib Jüri tehnopargis Kalev Spordis näitamiseks Venezuela seebiseriaali Eesti oludele mugandust "Kalevi naised" (lavastaja Ingomar Vihman, osades Maria Avdjuško, Toomas Zupping, Jan Uuspõld, Britta Vahur, Ken Saan jt). Filmivõtetelt

Võidusamba klaasimine algab järgmisel nädalal / Urmas Tooming

Index Scriptorium Estoniae

Tooming, Urmas

2008-01-01

Tallinnasse rajatava Vabadussõja võidusamba betoonsüdamiku ümber ehitatakse metallkarkass, mille külge kinnitatakse klaasplokid. Töid teostab Tšehhi firma Sans Souc. Samba valguslahendusest. Kommenteerivad Kalev Pikaru firmast Telora-E ja disainer Andri Laidre

A Case of Shunting Postoperative Patent Foramen Ovale Under Mechanical Ventilation Controlled by Different Ventilator Settings.

Science.gov (United States)

Pragliola, Claudio; Di Michele, Sara; Galzerano, Domenico

2017-06-07

A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE) performed while the patient was being ventilated at a positive end expiratory pressure (PEEP) of 8 cm H 2 O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO). Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H 2 O led to the complete resolution of the shunt with no change in arterial blood gases. Attempts to increase the PEEP level above 3 mmHg resulted in recurrence of the interatrial shunt. The remaining of the TEE was unremarkable. Mechanical ventilation, particularly with PEEP, causes an increase in intrathoracic pressure. The resulting rise in right atrial pressure, mostly during inspiration, may unveil and pop open an unrecognized PFO, thus provoking a right to left shunt across a seemingly intact interatrial septum. This phenomenon increases the risk of paradoxical embolism and can lead to hypoxemia. The immediate management would be to adjust the ventilatory settings to a lower PEEP level. A routine search for a PFO should be performed in ventilated patients who undergo a TEE.

A case of shunting postoperative patent foramen ovale under mechanical ventilation controlled by different ventilator settings

Directory of Open Access Journals (Sweden)

Claudio Pragliola

2017-08-01

Full Text Available A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE performed while the patient was being ventilated at a positive end expiratory pressure (PEEP of 8 cm H2O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO. Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H2O led to the complete resolution of the shunt with no change in arterial blood gases. Attempts to increase the PEEP level above 3 mmHg resulted in recurrence of the interatrial shunt. The remaining of the TEE was unremarkable. Mechanical ventilation, particularly with PEEP, causes an increase in intrathoracic pressure. The resulting rise in right atrial pressure, mostly during inspiration, may unveil and pop open an unrecognized PFO, thus provoking a right to left shunt across a seemingly intact interatrial septum. This phenomenon increases the risk of paradoxical embolism and can lead to hypoxemia. The immediate management would be to adjust the ventilatory settings to a lower PEEP level. A routine search for a PFO should be performed in ventilated patients who undergo a TEE.

A Recruiting Maneuver Algorithm in Patients with Early Acute Respiratory Distress Syndrome

Directory of Open Access Journals (Sweden)

D. I. Levikov

2011-01-01

Full Text Available Objective: to evaluate the efficiency of a recruiting maneuver (RM and adjustment of positive end-expiratory pressure (PEEP in patients with early acute respiratory distress syndrome (ARDS. Subjects and methods. The study enrolled 16 patients (14 men and 2 women aged 46 to 78 years (range 62±5.6 years with ARDS of various genesis. RM was made, by stepwisely increasing PEEP and inspiratory pressure under the control of dynamic lung compliance and hemodynamic parameters. The values of blood gas composition and hemodynamics were determined during the study. Results. RM caused an increase in oxygenation index (OI from 153.5±48.3 to 348.5±53.2 mm Hg. Oxygenation values returned to the baseline levels 30—40 min after the PEEP was set at the closure point of +2 cm H2O. If the set PEEP was 8—10 cm H2O higher than the objective, the effect of RM was retained for as long as 24 hours. When RM was performed using the maximum pressure of 50—60 cm H2O, the cardiac index (CI was lower in all the patients and 30—50% of the baseline values were achieved in all cases, which required the optimization of cardiotonic therapy. The time of this pronounced reduction in cardiac output with RM was not longer than 5 min. After RM, during mechanical ventilation with 18—26 cm H2O PEEP, the CI did not practically differ from the baseline values (3.31±0.41 and 3.37±0.36 l/min/m2, respectively, though the dopamine dose required to maintain normal hemodynamics was somewhat higher (7.5±2.3 and 6.3±2.6 ^g/kg/min. Conclusion. Analysis of the given cases suggests that RM is highly effective in patients at the early stages of acute lung injury. The duration of RM effects may depend on the set PEEP level in individual cases. Setting PEEP at a level of +2—4 cm H2O fails to prevent repeated alveolar derecruitment in a number of patients. In these cases, it is expedient to individually adjust PEEP levels, by taking into account the long-term changes in OI and Cdyn. In

Vahejuhtum kassas / Krister Kivi

Index Scriptorium Estoniae

Kivi, Krister, 1975-

2008-01-01

Alta Capitali juhist Indrek Rahumaa karjäärist ja varasematest tehingutest. Oliver Kruuda firmade Kalev ja Tere müügiläbirääkimiste katkemine võib Rahumaale kaasa tuua 141 miljoni kroonise finantskaotuse. Lisa: Indrek Rahumaa

Dzhentelmenide kätsh / Hannes Sarv

Index Scriptorium Estoniae

Sarv, Hannes

2008-01-01

AS Alta Foods esitas Stockholmi arbitraazhiinstituudile taotluse, et saada tagasi AS-i Kalev toiduainetööstuse ja AS-i Tere omandamiseks tasutud kuue miljoni euro suurune ettemaks. Vt. samas: Tehingu kronoloogia. Küsimustele vastavad Indrek Rahumaa ja Oliver Kruuda

Sisekommunikatsiooni roll on toidutööstuses kriitilise kaaluga / Kairi Oja

Index Scriptorium Estoniae

Oja, Kairi

2015-01-01

Toidutööstuse sisekommunikatsioonist. Selgitusi jagavad Coca-Cola HBC Eesti avalike suhete juht Nele Normak, Jako Arula ettevõttest AS A. Le Coq, AS-i Kalev kommunikatsioonijuht Rutt Roht ja Eesti Toiduainetööstuse Liidu juhataja Sirje Potisepp

50 miljoni kulutamise eesmärk : 50 miljonit tuleb kulutada ja kõik / Raimo Poom

Index Scriptorium Estoniae

Poom, Raimo

2007-01-01

Ministeeriumid kritiseerivad majandus- ja kommunikatsiooniministeeriumi kodutoetuse seaduse eelnõu, mille eesmärk on lahendada lasterikaste perede eluasemeprobleemid. Siim Valmar Kiisleri, Jürgen Ligi, majandus- ja kommunikatsiooniministeeriumi pressiesindaja Kalev Vapperi arvamusi. Vt. samas: Kadri Ibrus. Viielapseline pere laenu ei saa

Jalgrattur Sigvard Kukk : naisi tuleks lilledega loopida / Andres Kalvik

Index Scriptorium Estoniae

Kalvik, Andres, 1982-

2007-01-01

Kalev Chocolate Teami kuuluvad jalgratturid Mart Ojavee ja Priit Prous koos elukaaslaste Fia Metsamägi ja Kaia-Liia Ilumetsaga räägivad paarisuhtest olukorras, kui mees enamiku ajast välismaal viibib. Lisa: Enamik rattureid vahetab spordist loobudes naist

Eesti harrastusfilm võitis esikoha

Index Scriptorium Estoniae

2007-01-01

Tallinna V rahvusvahelise amatöörfilmide festivali peaauhind jagunes nelja filmi vahel, millest üks oli Eesti "Elevanti nägema" (tegijad Sandra Dürdorth, Maureen Apel, Kalev Saar, Leon Shamis). Teised võitjad olid Austria (2 filmi) ja Soome

Keskkond / Peep Pobbul

Index Scriptorium Estoniae

Pobbul, Peep

2004-01-01

Ilmunud ka: 2003 : annual report : [Eesti Raudtee]. - Tallinn, 2004, lk. 40-41; 2003 : godovoi ottshjot : [Eesti Raudtee]. - Tallinn, 2004, lk. 40-41. AS-i Eesti Raudtee keskkonna-alastest projektidest

The Peep Show

Science.gov (United States)

Gamble, David L.

2010-01-01

Three years ago, the author and Linda Arbuckle (University of Florida ceramic professor and internationally known majolica clay artist) were on the phone discussing how electric kilns just don't have any artistic design flair to them. The round kiln has basic properties that allow it to function properly, but its looks are far from exciting. They…

The effects of intraoperative lung protective ventilation with positive end-expiratory pressure on blood loss during hepatic resection surgery: A secondary analysis of data from a published randomised control trial (IMPROVE).

Science.gov (United States)

Neuschwander, Arthur; Futier, Emmanuel; Jaber, Samir; Pereira, Bruno; Eurin, Mathilde; Marret, Emmanuel; Szymkewicz, Olga; Beaussier, Marc; Paugam-Burtz, Catherine

2016-04-01

During high-risk abdominal surgery the use of a multi-faceted lung protective ventilation strategy composed of low tidal volumes, positive end-expiratory pressure (PEEP) and recruitment manoeuvres, has been shown to improve clinical outcomes. It has been speculated, however, that mechanical ventilation using PEEP might increase intraoperative bleeding during liver resection. To study the impact of mechanical ventilation with PEEP on bleeding during hepatectomy. Post-hoc analysis of a randomised controlled trial. Seven French university teaching hospitals from January 2011 to August 2012. Patients scheduled for liver resection surgery. In the Intraoperative Protective Ventilation trial, patients scheduled for major abdominal surgery were randomly assigned to mechanical ventilation using low tidal volume, PEEP between 6 and 8  cmH2O and recruitment manoeuvres (lung protective ventilation strategy) or higher tidal volume, zero PEEP and no recruitment manoeuvres (non-protective ventilation strategy). The primary endpoint was intraoperative blood loss volume. A total of 79 (19.8%) patients underwent liver resections (41 in the lung protective and 38 in the non-protective group). The median (interquartile range) amount of intraoperative blood loss was 500 (200 to 800)  ml and 275 (125 to 800)  ml in the non-protective and lung protective ventilation groups, respectively (P = 0.47). Fourteen (35.0%) and eight (21.5%) patients were transfused in the non-protective and lung protective groups, respectively (P = 0.17), without a statistically significant difference in the median (interquartile range) number of red blood cells units transfused [2.5 (2 to 4) units and 3 (2 to 6) units in the two groups, respectively; P = 0.54]. During hepatic surgery, mechanical ventilation using PEEP within a multi-faceted lung protective strategy was not associated with increased bleeding compared with non-protective ventilation using zero PEEP. The current study was not

Do we deliver the pressures we intend to when using a T-piece resuscitator?

Directory of Open Access Journals (Sweden)

Evelien Roegholt

Full Text Available BACKGROUND: A T-piece resuscitator (TPR uses a built-in manometer to set the inflation pressures, but we are not informed what pressures are actually delivered distally. Aim of this study was to measure the proximal and distal pressures under different gas conditions when using a TPR. METHODOLOGY/FINDINGS: A test lung was ventilated using a TPR (PIP 25 cmH₂O, PEEP 5 cmH₂O with a gas flow rate of 8 L/min. A Pressure delivered by six different TPRs was tested. To test variability 20 participants were asked to set PEEP and PIP pressures to 25/5 cmH₂O. B PIP and PEEP were measured proximal and distal of the TPR when using standard tubing or heated tubing with or without a humidifier. In experiment A mean (SD proximal PIP and PEEP of the TPRs were respectively 20.3 (0.3 cmH₂O (19.9-20.6 cmH₂O and 4.9 (0.1 cmH₂O. When 20 participants set pressures; PIP 26.7 (0.5 cm H₂O and PEEP 5.9 (0.44 cmH2O were measured. Experiment B showed that the decrease of PIP between proximal and distal pressures was not clinically significant. However there was a significant decrease of PEEP using the standard tubing (5.1 (0.1 cmH₂O proximally versus 4.8 (0.2 cmH₂O distally; p<0.001 compared to, when using a humidifier with associated tubing and the humidifier turned on, 5.1 (0.1 proximally versus 3.9 (0.2 cmH₂O distally; (p<0.001. CONCLUSION/SIGNIFICANCE: The accuracy of the built-in manometer of a TPR is acceptable. Most pressures set proximally are comparable to the actual pressures delivered distally. However, when using tubing associated with the humidifier PEEP decreases distally by 1.1-1.2 cmH₂O and users should anticipate on this.

Toetame Valgevenet / Kalev Kallemets

Index Scriptorium Estoniae

Kallemets, Kalev, 1979-

2006-01-01

Autor arvab, et demokraatia võiduletulekule Valgevenes aitaks kaasa Aleksandr Lukashenko mitte tunnustamine Valgevene presidendina, samuti tuleks toetada moraalselt ja aineliselt Valgevene opositsiooni. Valgevene majanduslik ning poliitiline toetamine Venemaa poolt tuleks muuta võimalikult ebemugavaks

Põgenemine Egiptusest / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2005-01-01

Terrorirünnakust Sharm el-Sheikhi luksushotellis Chazala Gardens'is, vastutusevõtjaks on end nimetanud nii rühmitus "Egiptuse Modzhaeedid" (Egiptuse Pühad Sõdalased) kui ka Abdullah Azzami Brigaad

Üliõpilasteatrid peavad Itaalias kongressi

Index Scriptorium Estoniae

2006-01-01

Itaalia väikelinnas Urbinos lõpeb 27. juulil sealse ülikooli teatri Teatro Aenigma ja Rahvusvahelise Üliõpilasteatrite Assotsiatsiooni koostöös kuues tudengiteatrite maailmakongress. Eestist osaleb ja peab ettekande lavastaja ja Tartu Üliõpilasteatri kunstiline juht Kalev Kudu

Kaasaegse kunsti muuseum asutas iga-aastase Köleri auhinna / Mart Niineste

Index Scriptorium Estoniae

Niineste, Mart, 1983-

2011-01-01

EKKM-i poolt nimetatud Köler Prize 2011 nominendid on Dénes Kalev Farkas, Tõnis Saadoja, Timo Toots, Sigrid Viir ja Jevgeni Zolotko. Laureaadi valib rahvusvaheline žürii EKKM-is 1. maist 5. juunini toimuva näituse põhjal. Kunstiauhinnast

Faced with an alternative : A failed submarine deal / Magnus Ilmjärv

Index Scriptorium Estoniae

Ilmjärv, Magnus, 1961-

2007-01-01

Saksamaa soovist osta Eestilt allveelaevad Kalev ja Lembit. Kartus avaliku arvamuse, ühe osa sõjaväelaste ja ka Nõukogude Liidu reaktsiooni ees ning maa okupeerimine Nõukogude Liidu poolt olid põhjused, miks allveelaevade Saksamaale mahamüümine ei õnnestunud

AGG Maailmameistrivõistluste eel

Index Scriptorium Estoniae

2008-01-01

12.-14. juunini toimuvad Torontos Aesthetic Group Gymnastics (AGG) maailmameistrivõistlused Toronto Ülikooli võimlemiskeskuses. Nende võistluste korraldamise raske ülesande on võtnud oma õlule Kanada eestlaste võimlemisklubid Kalev Estienne ja Ritmika vastavalt Evelyn Koobi ja Annely Riga juhtimisel

Naised käsu korras firmade juhatusse! Jah või ei? / Kairi Alt, Aveli Kippari, Karl Koort... [jt.

Index Scriptorium Estoniae

2011-01-01

Küsimusele vastavad Columbus IT Partner Eesti AS personalijuht Kairi Alt, Stele ja Riveli omanik Aveli Kippari, AS Panaviatic'i turundusjuht Karl Koort, OÜ Tarkvara Tehnoloogia Arenduskeskuse tegevjuht Indrek Vainu, AS PricewaterhouseCoopers auditiosakonna direktor Eva Jansen, Kalev Chocolate Factory tootmisjuht Hardo Reinike

Leading Estonian brands in the hands of foreign companies / Andreas Kaju

Index Scriptorium Estoniae

Kaju, Andreas

2002-01-01

Emori poolt 2002. aasta alguses läbi viidud uurimusest selgus, et Eesti top 10 kaubamärkide hulgas on Kalev ainus Eesti kapitalil põhineva ettevõtte kaubamärk. Tabel: Eesti ettevõtete ja kaubamärkide top 6. Lisa

Väätsa Agro müüdud / Silja Lättemäe

Index Scriptorium Estoniae

Lättemäe, Silja, 1952-

2006-01-01

Eesti suurima põllumajandusettevõtte Väätsa Agro OÜ üle 56% suurosaluse omandas Eesti kapitalil tegutsev osaühing Windmühle. Vt. samas: Miks te ei maksa piimavõlga ära? Küsimusele vastab AS-i Kalev omanik Oliver Kruuda

Laul, mis kõlas Venemaal paremini kui Eestis / Riho Nagel

Index Scriptorium Estoniae

Nagel, Riho

2018-01-01

Tapal asuva 1. jalaväebrigaadi staabi- ja sidekompanii ajateenijad valisid oma kompanii lauluks "Metsavendade laulu". Vene rahvusest ajateenija kaebuse tõttu laulust küll loobuti, kuid info sellest laulust jõudis Vene meediasse. Rahvusvahelise kaitseuuringute keskuse teaduri Kalev Stoicescu kommentaar

Nonassociative learning promotes respiratory entrainment to mechanical ventilation.

Directory of Open Access Journals (Sweden)

Shawna M MacDonald

Full Text Available BACKGROUND: Patient-ventilator synchrony is a major concern in critical care and is influenced by phasic lung-volume feedback control of the respiratory rhythm. Routine clinical application of positive end-expiratory pressure (PEEP introduces a tonic input which, if unopposed, might disrupt respiratory-ventilator entrainment through sustained activation of the vagally-mediated Hering-Breuer reflex. We suggest that this potential adverse effect may be averted by two differentiator forms of nonassociative learning (habituation and desensitization of the Hering-Breuer reflex via pontomedullary pathways. METHODOLOGY/PRINCIPAL FINDINGS: We tested these hypotheses in 17 urethane-anesthetized adult Sprague-Dawley rats under controlled mechanical ventilation. Without PEEP, phrenic discharge was entrained 1:1 to the ventilator rhythm. Application of PEEP momentarily dampened the entrainment to higher ratios but this effect was gradually adapted by nonassociative learning. Bilateral electrolytic lesions of the pneumotaxic center weakened the adaptation to PEEP, whereas sustained stimulation of the pneumotaxic center weakened the entrainment independent of PEEP. In all cases, entrainment was abolished after vagotomy. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate an important functional role for pneumotaxic desensitization and extra-pontine habituation of the Hering-Breuer reflex elicited by lung inflation: acting as buffers or high-pass filters against tonic vagal volume input, these differentiator forms of nonassociative learning help to restore respiratory-ventilator entrainment in the face of PEEP. Such central sites-specific habituation and desensitization of the Hering-Breuer reflex provide a useful experimental model of nonassociative learning in mammals that is of particular significance in understanding respiratory rhythmogenesis and coupled-oscillator entrainment mechanisms, and in the clinical management of mechanical ventilation in

Kruuda tahab Kalevi ja Tere ikkagi Altale müüa / Hindrek Riikoja

Index Scriptorium Estoniae

Riikoja, Hindrek

2008-01-01

Oliver Kruuda firmade Kalev ja Tere müügiläbirääkimiste katkemisest Altaga. Alta Capitali juhi Indrek Rahumaa sõnul loodetakse müügilepinguni jõuda aasta teises pooles. Lisa: Mille üle läbi räägiti

Ebaõnnestunud müügitehing tõi Kalevile kohtuasja ja varade aresti / Dannar Leitmaa

Index Scriptorium Estoniae

Leitmaa, Dannar, 1982-

2008-01-01

Harju maakohus andis loa arestida Oliver Kruudale kuuluva Kalevi ja selle tütarfirmade varad, kuna Alta Foodsi poolt Kalevi toiduainetööstuse omandamiseks makstud kuus miljonit eurot tagatisraha kuulub väljamaksmisele tehingu katkemise korral. Lisa: Kalev nõuab 141 miljonit krooni

"on yks niisugune film..." : [luuletused] / [Mesikepp, Indrek] fs

Index Scriptorium Estoniae

fs, pseud., 1971-

2007-01-01

Sisu: "on yks niisugune film..." ; "kui kord Kalev koju jõuab..." ; "niisiis te arvate kõike teadvat..." ; "ytle mulle ausalt kastead..." ; "they are so bleak..." ; "yhel ööl ma tajusin surma..." ; "ma tundsin et see või veel juhtuda..." ; "kui kylm alumiiniumist joon..."

"Kalevi naised" - komöödia, kus nalja ei tehta / Verni Leivak

Index Scriptorium Estoniae

Leivak, Verni, 1966-

2008-01-01

Produtsent Kristian Taska filmib Jüri tehnopargis Kalev Spordis näitamiseks Venezuela seebiseriaali Eesti oludele mugandust "Kalevi naised" (lavastaja Ingomar Vihman, telerežissöör Hermes Brambat, osades Maria Avdjuško, Andrus Vaarik, Jan Uuspõld, Britta Vahur, Ken Saan jt)

Kiviõli politsei jättis hätta neli korda abi palunud mehe / Frank Sprenk-Dorn

Index Scriptorium Estoniae

Sprenk-Dorn, Frank

2004-01-01

Kiviõli lähistel Erra külas kolm autovarast kinni pidanud Mati Vilumets süüdistab politseid tema väljakutsetele reageerimata jätmises, politsei hinnangul ei olnud tema kõned üheselt mõistetavad. Kommenteerib Ida politseiprefekt Kalev Prillop

Agar pronkssõduriga võitleja sai kanepisuitsetamise eest trahvi / Katrin Rohtla, Siim Randla

Index Scriptorium Estoniae

Rohtla, Katrin, 1966-

2006-01-01

Aktiivse pronkssõduri vastasena tuntust kogunud Isamaaliidu liige Kalev Rebane sai Läänemaal Peraküla rannas kanepi suitsetamise eest politseilt 9000 krooni trahvi. Isamaa ja Res Publica Liidu liikmed on teinud ettepaneku noormees erakonnast välja arvata. Lisa: Mille eest koostati protokoll?

Piiritagune teater huvitab igat näitlejat / Kadri Bank

Index Scriptorium Estoniae

Bank, Kadri

2006-01-01

VIIIndast rahvusvahelisest sõltumatute ja amatöörteatrite festivalist "Apostrof" Prahas 30. VII - 4. VIII, kus osales ka Tartu Üliõpilasteater lavastusega "Puhastatud" (autor Sarah Kane, lavastaja Kalev Kudu). Lavastus pälvis publikuhääletusel 14 osaleja seas viienda koha

Eksperdid peavad võrdlust Kuuba kriisiga liialduseks / Evelyn Kaldoja

Index Scriptorium Estoniae

Kaldoja, Evelyn, 1980-

2016-01-01

Balti riikide ja teiste Venemaa naaberriikide julgeolekust seoses Iskander-M-tüüpi rakettide paigutamisega Kaliningradi oblastisse. NATO liitlasvägede kohalolust Baltimaades ja Poolas ning mõjudest Venemaa julgeolekupoliitilistele otsustele. Rahvusvahelise Kaitseuuringute Keskuse teadurite Tomas Jermalavičiuse ja Kalev Stoicescu kommentaarid

Omamise vaev või rendiõnn? / Merlis Nõgene

Index Scriptorium Estoniae

Nõgene, Merlis, 1976-

2006-01-01

Arvutite renditeenust tutvustavad Elioni finantseerimistoodete teenistuse juhataja Kalev Karus, Siemens Financial Services'i tegevjuht Virgo Jaani ja 3 Step IT müügidirektor Aivar Kraus. Kommenteerib Infoweb ASi arendusdirektor Tauri Purkas. Lisad: Rentimise plussid ja miinused; Tallinna koolide arvutite renditsükkel purunes

Low pulmonary artery flush perfusion pressure combined with high positive end-expiratory pressure reduces oedema formation in isolated porcine lungs

International Nuclear Information System (INIS)

Schumann, Stefan; Schließmann, Stephan J; Wagner, Giskard; Goebel, Ulrich; Priebe, Hans-Joachim; Guttmann, Josef; Kirschbaum, Andreas

2010-01-01

Flush perfusion of the pulmonary artery with organ protection solution is a standard procedure before lung explantation. However, rapid flush perfusion may cause pulmonary oedema which is deleterious in the lung transplantation setting. In this study we tested the hypotheses that high pulmonary perfusion pressure contributes to the development of pulmonary oedema and positive end-expiratory pressure (PEEP) counteracts oedema formation. We expected oedema formation to increase weight and decrease compliance of the lungs on the basis of a decrease in alveolar volume as fluid replaces alveolar air spaces. The pulmonary artery of 28 isolated porcine lungs was perfused with a low-potassium dextrane solution at low (mean 27 mmHg) or high (mean 40 mmHg) pulmonary artery pressure (PAP) during mechanical ventilation at low (4 cmH 2 O) or high (8 cmH 2 O) PEEP, respectively. Following perfusion and storage, relative increases in lung weight were smaller (p < 0.05) during perfusion at low PAP (62 ± 32% and 42 ± 26%, respectively) compared to perfusion at high PAP (133 ± 54% and 87 ± 30%, respectively). Compared to all other PAP–PEEP combinations, increases in lung weight were smallest (44 ± 9% and 27 ± 12%, respectively), nonlinear intratidal lung compliance was largest (46% and 17% respectively, both p < 0.05) and lung histology showed least infiltration of mononuclear cells in the alveolar septa, and least alveolar destruction during the combination of low perfusion pressure and high PEEP. The findings suggest that oedema formation during pulmonary artery flush perfusion in isolated and ventilated lungs can be reduced by choosing low perfusion pressure and high PEEP. PAP–PEEP titration to minimize pulmonary oedema should be based on lung mechanics and PAP monitoring

[A comparison of leak compensation in six acute care ventilators during non-invasive ventilation].

Science.gov (United States)

Hu, X S; Wang, Y; Wang, Z T; Yan, P; Zhang, X G; Zhao, S F; Xie, F; Gu, H J; Xie, L X

2017-02-12

Objective: To compare the ability of leak compensation in 6 medical ventilators during non-invasive ventilation. Methods: Six medical ventilators were selected, including 3 non-invasive ventilators (V60, Flexo and Stellar150), and 3 invasive ventilators(Avea, Servo I and BellaVist). Using a lung simulator, the ability of leak compensation was evaluated during triggering and cycling in 2 respiratory mechanics conditions (high airway resistance condition and high elastance resistance condition), and each condition was performed under 2 PEEP levels (4, and 8 cmH(2)O, 1 mmHg=0.098 kPa) at 4 air leak level conditions (L0: 2-3 L/min, L1: 8-10 L/min, L2: 22-27 L/min, L3: 35-40 L/min). Results: In the high elastance resistance condition (L2, L3)with different leak levels, the number of auto-triggering and miss-triggering of the non-invasive ventilator Flexo was significantly less than those of the others (L2: 1, 1; L3: 1.67, 1.33, P ventilators ( P ventilators (1, 0.67, 0, P ventilators in both high airway resistance and high elastance resistance conditions with L0 and L1 leak levels and PEEP levels [ARDS, PEEP=4: (109.8±1.8) ms, (112.0±0.6) ms; ARDS, PEEP=8: (103.1±0.7) ms, (109.7±0.7) ms; COPD, PEEP=4: (207.3±1.1) ms, (220.8±1.1) ms; COPD, PEEP=8: (195.6±6.7) ms, (200.0±1.2) ms , P ventilators could be synchronized, among which V60, Stellar150 and Flexo presented a good performance features in specific conditions.

Within-breath arterial PO2 oscillations in an experimental model of acute respiratory distress syndrome.

Science.gov (United States)

Williams, E M; Viale, J P; Hamilton, R M; McPeak, H; Sutton, L; Hahn, C E

2000-09-01

Tidal ventilation causes within-breath oscillations in alveolar oxygen concentration, with an amplitude which depends on the prevailing ventilator settings. These alveolar oxygen oscillations are transmitted to arterial oxygen tension, PaO2, but with an amplitude which now depends upon the magnitude of venous admixture or true shunt, QS/QT. We investigated the effect of positive end-expiratory pressure (PEEP) on the amplitude of the PaO2 oscillations, using an atelectasis model of shunt. Blood PaO2 was measured on-line with an intravascular PaO2 sensor, which had a 2-4 s response time (10-90%). The magnitude of the time-varying PaO2 oscillation was titrated against applied PEEP while tidal volume, respiratory rate and inspired oxygen concentration were kept constant. The amplitude of the PaO2 oscillation, delta PaO2, and the mean PaO2 value varied with the level of PEEP applied. At zero PEEP, both the amplitude and the mean were at their lowest values. As PEEP was increased to 1.5 kPa, both delta PaO2 and the mean PaO2 increased to a maximum. Thereafter, the mean PaO2 increased but delta PaO2 decreased. Clear oscillations of PaO2 were seen even at the lowest mean PaO2, 9.5 kPa. Conventional respiratory models of venous admixture predict that these PaO2 oscillations will be reduced by the steep part of the oxyhaemoglobin dissociation curve if a constant pulmonary shunt exists throughout the whole respiratory cycle. The facts that the PaO2 oscillations occurred at all mean PaO2 values and that their amplitude increased with increasing PEEP suggest that QS/QT, in the atelectasis model, varies between end-expiration and end-inspiration, having a much lower value during inspiration than during expiration.

Männik ohverdas Aaviksoo

Index Scriptorium Estoniae

2003-01-01

Eesti Telekomi nõukogu otsusest vabastada ametist EMT juhatuse esimees Peep Aaviksoo, uuest kandidaadist Valdo Kalmust ning EMT ja Elioni võimalikust ühinemisest. Diagramm: EMT turuosa libiseb Tele2-le. Vt. samas: EMT lahkuva juhi Peep Aaviksoo avalik kiri. Kommenteerivad Sami Seppänen, Üllar Jaaksoo, Monika Salu, Jaak Aaviksoo, Toomas Tamsar

Ettevõtted panustavad eelarve koostamisel järjest enam spetsialistide täiendkoolitusse / Madli Kents

Index Scriptorium Estoniae

Kents, Madli

2005-01-01

AS-i Kalev koolitusspetsialist Gerli Jõgi, Hansapanga koolituse ostujuht Katrin Kase ja AS-i Eesti Energia koolitusjuht Erge Heido selgitavad, millele pööratakse tähelepanu nende ettevõttes koolituseelarve koostamisel ning annavad ülevaate rakendatavatest koolitusvormidest. Vt. samas: Marja Liis. Esiplaanil on teenindajad

Poliitikud ei leidnud staadioni planeeringule uusi lahendusi / Eno-Gerrit Link

Index Scriptorium Estoniae

Link, Eno-Gerrit

2008-01-01

Riigikogu Pärnumaa saadikuteühenduse ja Pärnu linnavõimu esindajate ning spordiseltsi Kalev juhtide nõupidamine Kalevi staadioni ümberehituse käimalükkamiseks lõppes tulemusteta, sest kõiki osapooli rahuldava tulemuseni ei jõutud. Kommenteerivad Mark Soosaar ja Vello Järvesalu

"Su mõte on see, mida elad" : vanadus / Kaire Nurk

Index Scriptorium Estoniae

Nurk, Kaire, 1960-

2005-01-01

Reet Varblase kuraatoriprojektist "Homo grandis natu" Tallinna Kunstihoones kuni 15. V. Tallinna Kunstikooli õpilaste (õpetaja Katrin Tukmann), Katarzyna Kozyra, Eveli Variku, Marge Monko, Piia Ruberi & Doris Kareva ja Mare Mikofi töödest, Tallinna Ülikooli audiovisuaalkunsti osakonnas tehtud filmidest (Elen Lotman, Jaak Kilmi, Kalev Hiller)

Neli vaadet tuumale ja näivusele / Märt Väljataga

Index Scriptorium Estoniae

Väljataga, Märt, 1965-

2009-01-01

Arvustus: Tuglas, Friedebert. Valik proosat / koostanud ja saatetekstid kirjutanud Jaan Undusk. Tallinn : Avita, 2009 ; Nietzsche, Friedrich. Tragöödia sünd. Tallinn : Tänapäev, 2009 ; Kesküla, Kalev. Elu sumedusest. Tallinn : Tuum, 2009 ; Sirkel, Mati. Uued orva-aastad. Kommentaarium. Tallinn : Tuum, 2009

Koole hakkavad haldama riiulifirmad / Toivo Tänavsuu, Vallo Toomet

Index Scriptorium Estoniae

Tänavsuu, Toivo

2006-01-01

Kümme Tallinna kooli antakse 30 aastaks erafirmade renoveerida ja hallata. 32. keskkooli majandusjuhi Ants Ivaski, Kalev REC juhatuse liikme Peeter Lillestiku, U. S. Investi juhatuse liikme Tarmo Tomaki, RKAS-i juhi Jaak Saarniidu seisukohti. Vt. samas intervjuud Kaia Jäppineniga. Lisa: Rendisumma erineb mitu korda

Alo Streimann pääses Eesti Posti juhatusse suunatud konkursiga / Tõnis Arro ; interv. Toomas Kümmel

Index Scriptorium Estoniae

Arro, Tõnis

2003-01-01

Personaliotsingufirma Fontes nõukogu esimees Tõnis Arro tunnistab, et Eesti Posti juhi kohalt tagasiastunud Alo Streimanni ametisse valimisel oli tunda ettevõtte eelmise nõukogu soovi suruda sellele ametikohale Keskerakonnale lähedalseisev inimene. Vt. samas: Aastatagused arvamused Alo Streimannist: Kalev Kaal, Kostel Gerndorf, Küllo Arjakas

Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.

LENUS (Irish Health Repository)

McCaul, Conán

2009-10-01

Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

Bench performance of ventilators during simulated paediatric ventilation.

Science.gov (United States)

Park, M A J; Freebairn, R C; Gomersall, C D

2013-05-01

This study compares the accuracy and capabilities of various ventilators using a paediatric acute respiratory distress syndrome lung model. Various compliance settings and respiratory rate settings were used. The study was done in three parts: tidal volume and FiO2 accuracy; pressure control accuracy and positive end-expiratory pressure (PEEP) accuracy. The parameters set on the ventilator were compared with either or both of the measured parameters by the test lung and the ventilator. The results revealed that none of the ventilators could consistently deliver tidal volumes within 1 ml/kg of the set tidal volume, and the discrepancy between the delivered volume and the volume measured by the ventilator varied greatly. The target tidal volume was 8 ml/kg, but delivered tidal volumes ranged from 3.6-11.4 ml/kg and the volumes measured by the ventilator ranged from 4.1-20.6 ml/kg. All the ventilators maintained pressure within 20% of the set pressure, except one ventilator which delivered pressures of up to 27% higher than the set pressure. Two ventilators maintained PEEP within 10% of the prescribed PEEP. The majority of the readings were also within 10%. However, three ventilators delivered, at times, PEEPs over 20% higher. In conclusion, as lung compliance decreases, especially in paediatric patients, some ventilators perform better than others. This study highlights situations where ventilators may not be able to deliver, nor adequately measure, set tidal volumes, pressure, PEEP or FiO2.

Effects of positive end-expiratory pressure on intraoperative core temperature in patients undergoing posterior spine surgery: prospective randomised trial.

Science.gov (United States)

Seo, Hyungseok; Do Son, Je; Lee, Hyung-Chul; Oh, Hyung-Min; Jung, Chul-Woo; Park, Hee-Pyoung

2018-03-01

Objective Positive end-expiratory pressure (PEEP) causes carotid baroreceptor unloading, which leads to thermoregulatory peripheral vasoconstriction. However, the effects of PEEP on intraoperative thermoregulation in the prone position remain unknown. Methods Thirty-seven patients undergoing spine surgery in the prone position were assigned at random to receive either 10 cmH 2 O PEEP (Group P) or no PEEP (Group Z). The primary endpoint was core temperature 180 minutes after intubation. Secondary endpoints were delta core temperature (difference in core temperature between 180 minutes and immediately after tracheal intubation), incidence of intraoperative hypothermia (core temperature of peripheral vasoconstriction-related data. Results The median [interquartile range] core temperature 180 minutes after intubation was 36.1°C [35.9°C-36.2°C] and 36.0°C [35.9°C-36.4°C] in Groups Z and P, respectively. The delta core temperature and incidences of intraoperative hypothermia and peripheral vasoconstriction were not significantly different between the two groups. The peripheral vasoconstriction threshold (36.2°C±0.5°C vs. 36.7°C±0.6°C) was lower and the onset of peripheral vasoconstriction (66 [60-129] vs. 38 [28-70] minutes) was slower in Group Z than in Group P. Conclusions Intraoperative PEEP did not reduce the core temperature decrease in the prone position, although it resulted in an earlier onset and higher threshold of peripheral vasoconstriction.

Arco Vara laieneb Bulgaariasse

Index Scriptorium Estoniae

2006-01-01

Alates juunist tegutseb Bulgaarias Arco Vara Gruppi kuuluv maaklerfirma Arco Imoti EOOD, mis tegutseb rahvusvahelise kaubamärgi ARCO Real Estate all. Bulgaariasse on Eesti ettevõtetest oma tegevust laiendanud ka varahaldusfirma Delta Imoti Capital ja Kalev Real Estate Company kinnisvaraarendusega tegelev tütarettevõte Stude REC EOOD

Arupärimine rahandusministrile eurokalkulaatoritest / Jürgen Ligi, Ene Ergma, Helle Kalda...[jt.

Index Scriptorium Estoniae

2011-01-01

Riigikogu liikmete Helle Kalda, Toomas Vareki, Aivar Riisalu, Lauri Laasi, Mailis Repsi, Enn Eesmaa, Kalle Laaneti, Eldar Efendijevi, Nelli Privalova, Vladimir Velmani, Olga Sõtniku, Kalev Kallo, Toivo Tootseni, Arvo Sarapuu, Nikolai Põdramägi Evelyn Sepa, Ain Seppiku ja Valeri Korbi poolt 17. novembril esitatud arupärimine

Kalevi rooli asub endine lihatööstur / Kaisa Tahlfeld

Index Scriptorium Estoniae

Tahlfeld, Kaisa

2010-01-01

Endine Atria juht Kaido Kaare saab Kalev Chocolate Factory uueks juhiks. Kaare arvates võiksid Eesti magusatööstuse ambitsioonid ulatuda Eestist väljapoole, ta näeb võimalusi suurendada koostöös Orkla grupi ettevõtetega Kalevi tootmisefektiivsust ja jätkata tootearendust

Ledjanõje kopii izvestnõh pamjatnikov pojavilis v Tartu

Index Scriptorium Estoniae

2007-01-01

Kuus meeskonda Tartu Kõrgemast Kunstikoolist, Tartu Ülikoolist ja Tartu lastekunstikoolist lõikasid välja jääskulptuure, mis kopeerisid Eestimaa tuntud monumente. Võidutöö autor oli Kalev Järvik taiesega ±Energia¬. Tema töö on koopia Riho Kulla Narvas asuvast samanimelisest skulptuurist

Uued omanikud tahavad Revinost näidisfarmi teha / Külli Kriis

Index Scriptorium Estoniae

Kriis, Külli, 1961-

2004-01-01

Ilmunud ka: Severnoje Poberezhje, 9. jaan. 2004, lk. 4. Investeerimispank Trigon Capital omandas enamusosaluse osaühingus Revino. Pank kavatseb põllumajandusettevõttest kujundada näidisfarmi, mis aitaks muuta Eesti põllumajandust välisinvestoritele atraktiivsemaks Vt. samas lühiint. Kalev Mae, Ken Noble ja Joakim Heleniusega

Kalevite kange rahvas / Valter Lang

Index Scriptorium Estoniae

Lang, Valter, 1958-

2012-01-01

Autor uurib, kuidas võidi kutsuda sotsiaalselt paremal järjel olevaid inimesi muinasajal, juhtides tähelepanu ühele võimalusele omakeelse ülikunime väljaselgitamisel - selleks võiks olla meie rahvaluule vägilane Kalev. Pöördutakse nii rahvaluule, keeleajaloo kui ka arheoloogia poole

Kalev Spa : Aia tn. 18, Tallinn = Kalev Spa : Aia St. 18, Tallinn / Henry Kuningas

Index Scriptorium Estoniae

Kuningas, Henry

2006-01-01

"Kalevi" ujula ümberehitus. Projekteerija: AB Emil Urbel OÜ. Autorid: Emil Urbel, Ivar Lubjak. Sisekujundaja: Taavi Aunre (OÜ Boom.ee). Konstruktor: Margus Allik (MG Inseneribüroo OÜ). Projekt ja valmis: 2005. Ill.: I korruse plaan, 4 värv. vaadet

Uus kunst ootab vaatajaid augusti lõpuni

Index Scriptorium Estoniae

2006-01-01

Pärnu Uue Kunsti Muuseumi kollektsiooni esitlus "Sünnitus" Viljandis. Vaadata on Yoko Ono, Kalev Mark Kostabi, Edward Lucie-Smithi, Martin Garcia Rivera, Leonhard Lapini, Peeter Lauritsa, Enn Põldroosi jt. teosed. Reedeti on loomepäevad. 18. augustil näitab oma töid ja kõneleb Mark Soosaar

Directori ülesanne : Kangekaelsed alluvad / Marko Rillo

Index Scriptorium Estoniae

Rillo, Marko

2007-01-01

Ettevõtte juhi ja alluvate vahelistest probleemidest. Lahendusi kaasusele pakuvad Kalev Chocolate Factory AS-i juhatuse esimees Kati Kusmin: Rohkem usku iseendasse; firma Meeskonnakoolituse juhtimistreener-konsultant Ülo Vihma: Varem või hiljem saavutame ikka oma ebakompetentsuse taseme!; internetifirma Bookinghouse asutaja ja juht Andres Liinat: Oskused on õpitavad - isikuomadused mitte

Mis teeb ühe brand'i teistest paremaks? : Võidu tähendusrikkuse poole / Mauri Sööt

Index Scriptorium Estoniae

Sööt, Mauri

2013-01-01

Balti riikides läbi viidud brand'iuuringust Meaningful Brands, millega selgitati, kuidas brand'id mõjutavad inimese heaolu individuaalses ja kollektiivses tähenduses. Eestis uuritud 46 brand'i seas saavutas kõige kõrgema tähendusrikkuse indeksi magusatootja Kalev. Uuringutulemuste kasutusvõimalusi ettevõtte kommunikatsioonis ja üritusturunduses

Grigori Petrišin: Ajalehes Kesknädal 25. märtsil 2009 ilmunud publikatsiooni ümberlükkamine / Grigori Petrišin

Index Scriptorium Estoniae

Petrišin, Grigori

2009-01-01

Riigikogu liikme, endise Tallinna abilinnapea Kalev Kallo poole pöördus ettevõtja Grigori Petrišin, keda kaitsepolitsei oli sundinud väidetavalt oma firma nimel kirjutama linnajuhte kompromiteerivaid kirju. Nüüd väidab ettevõtja, et teda on ära kasutatud valimiseelsetes võimumängudes

Effects of a preemptive alveolar recruitment strategy on arterial oxygenation during one-lung ventilation with different tidal volumes in patients with normal pulmonary function test.

Science.gov (United States)

Jung, Jong Dal; Kim, Sang Hun; Yu, Byung Sik; Kim, Hye Ji

2014-08-01

Hypoxemia during one-lung ventilation (OLV) remains a major concern. The present study compared the effect of alveolar recruitment strategy (ARS) on arterial oxygenation during OLV at varying tidal volumes (Vt) with or without positive end-expiratory pressure (PEEP). In total, 120 patients undergoing wedge resection by video assisted thoracostomy were randomized into four groups comprising 30 patients each: those administered a 10 ml/kg tidal volume with or without preemptive ARS (Group H and Group H-ARS, respectively) and those administered a 6 ml/kg tidal volume and a 8 cmH2O PEEP with or without preemptive ARS (Group L and Group L-ARS, respectively). ARS was performed using pressure-controlled ventilation with a 40 cmH2O plateau airway pressure and a 15 cmH2O PEEP for at least 10 breaths until OLV began. Preemptive ARS significantly improved the PaO2/FiO2 ratio compared to the groups that did not receive ARS (P volume combined with 8 cmH2O PEEP after preemptive ARS may reduce the risk of pulmonary injury caused by high tidal volume during one-lung ventilation in patients with normal pulmonary function.

Spatial distribution of sequential ventilation during mechanical ventilation of the uninjured lung: an argument for cyclical airway collapse and expansion

Directory of Open Access Journals (Sweden)

Altemeier William A

2010-05-01

Full Text Available Abstract Background Ventilator-induced lung injury (VILI is a recognized complication of mechanical ventilation. Although the specific mechanism by which mechanical ventilation causes lung injury remains an active area of study, the application of positive end expiratory pressure (PEEP reduces its severity. We have previously reported that VILI is spatially heterogeneous with the most severe injury in the dorsal-caudal lung. This regional injury heterogeneity was abolished by the application of PEEP = 8 cm H2O. We hypothesized that the spatial distribution of lung injury correlates with areas in which cyclical airway collapse and recruitment occurs. Methods To test this hypothesis, rabbits were mechanically ventilated in the supine posture, and regional ventilation distribution was measured under four conditions: tidal volumes (VT of 6 and 12 ml/kg with PEEP levels of 0 and 8 cm H2O. Results We found that relative ventilation was sequentially redistributed towards dorsal-caudal lung with increasing tidal volume. This sequential ventilation redistribution was abolished with the addition of PEEP. Conclusions These results suggest that cyclical airway collapse and recruitment is regionally heterogeneous and spatially correlated with areas most susceptible to VILI.

Effects of respiratory rate, plateau pressure, and positive end-expiratory pressure on PaO2 oscillations after saline lavage.

Science.gov (United States)

Baumgardner, James E; Markstaller, Klaus; Pfeiffer, Birgit; Doebrich, Marcus; Otto, Cynthia M

2002-12-15

One of the proposed mechanisms of ventilator-associated lung injury is cyclic recruitment of atelectasis. Collapse of dependent lung regions with every breath should lead to large oscillations in PaO2 as shunt varies throughout the respiratory cycle. We placed a fluorescence-quenching PO2 probe in the brachiocephalic artery of six anesthetized rabbits after saline lavage. Using pressure-controlled ventilation with oxygen, ventilator settings were varied in random order over three levels of positive end-expiratory pressure (PEEP), respiratory rate (RR), and plateau pressure minus PEEP (Delta). Dependence of the amplitude of PaO2 oscillations on PEEP, RR, and Delta was modeled by multiple linear regression. Before lavage, arterial PO2 oscillations varied from 3 to 22 mm Hg. After lavage, arterial PO2 oscillations varied from 5 to 439 mm Hg. Response surfaces showed markedly nonlinear dependence of amplitude on PEEP, RR, and Delta. The large PaO2 oscillations observed provide evidence for cyclic recruitment in this model of lung injury. The important effect of RR on the magnitude of PaO2 oscillations suggests that the static behavior of atelectasis cannot be accurately extrapolated to predict dynamic behavior at realistic breathing frequencies.

Setting ventilation parameters guided by electrical impedance tomography in an animal trial of acute respiratory distress syndrome

Science.gov (United States)

Czaplik, Michael; Biener, Ingeborg; Leonhardt, Steffen; Rossaint, Rolf

2014-03-01

Since mechanical ventilation can cause harm to lung tissue it should be as protective as possible. Whereas numerous options exist to set ventilator parameters, an adequate monitoring is lacking up to date. The Electrical Impedance Tomography (EIT) provides a non-invasive visualization of ventilation which is relatively easy to apply and commercially available. Although there are a number of published measures and parameters derived from EIT, it is not clear how to use EIT to improve clinical outcome of e.g. patients suffering from acute respiratory distress syndrome (ARDS), a severe disease with a high mortality rate. On the one hand, parameters should be easy to obtain, on the other hand clinical algorithms should consider them to optimize ventilator settings. The so called Global inhomogeneity (GI) index bases on the fact that ARDS is characterized by an inhomogeneous injury pattern. By applying positive endexpiratory pressures (PEEP), homogeneity should be attained. In this study, ARDS was induced by a double hit procedure in six pigs. They were randomly assigned to either the EIT or the control group. Whereas in the control group the ARDS network table was used to set the PEEP according to the current inspiratory oxygen fraction, in the EIT group the GI index was calculated during a decremental PEEP trial. PEEP was kept when GI index was lowest. Interestingly, PEEP was significantly higher in the EIT group. Additionally, two of these animals died ahead of the schedule. Obviously, not only homogeneity of ventilation distribution matters but also limitation of over-distension.

Cardiac effects of positive pressure ventilation in ARDS assessed by NT-proBNP, Troponin T and Troponin I

Directory of Open Access Journals (Sweden)

Yasser Sadek Nassar

2013-01-01

Although the increase in cardiac markers are insignificant, yet they point to the potentially harmful role played by high PEEP, low PH and low PaO2/FiO2 ratio on the heart. Currently, no clinically relevant conclusion can be drawn apart from the recommendation to attempt to lower PEEP and shorten the duration of positive pressure ventilation, even in patients with structurally normal hearts.

Pärnu mnt. ja Järvevana tee vahelise ala planeerimiskonkurss = Planning Competition of the Area between Järvevana and Pärnu Roads / Kalle Komissarov

Index Scriptorium Estoniae

Komissarov, Kalle, 1976-

2002-01-01

Konkursist, zürii koosseis, võidutöödest. Võistlusala oli AS-i "Kalev" ja Tallinna Piimatööstuse territoorium. Preemiad: I - Nikolai Volkov, Liis Sagadi, II - Tarmo Teedumäe, Renee Puusepp, Karli Luik, Toomas Tammis, Inga Raukas, III - Veronika Valk, ostupreemiad - Alver Trummal Arhitektid ja büroo Kosmos

21. IV tähistasid Eesti Rahvusraamatukogus...

Index Scriptorium Estoniae

2004-01-01

Konverentsi ja näitusega tähistasid oma 80. aastapäeva Väärismetallasjade ja Märkide Tehas Roman Tavast OÜ ning OÜ Juveel. Konverentsil esinesid Raul-Roman Tavast, Kalev Uustalu, Vilius Kavaliauskas, Kaalu Kirme jt. Harulduste osakonna näitusesaalis kuni 21. V väljapanek tehases 80 aastal toodetust

Sise- ja rahvusvaheline tasakaal / Ragnar Nurkse ; tõlk. Aet Ringborg

Index Scriptorium Estoniae

Nurkse, Ragnar

2004-01-01

Keynesi majandusteooriast, rahvatulu ja väliskaubanduse seose multiplikaatoranalüüsist, tööhõivepoliitikast avatud majanduses ja selle rahvusvahelisest koordineerimisest, majanduslikust natsionalismist, rahvusvahelisest valuutapoliitikast ja multilateraalsest kaubandusest. Vt. ka: Kalev Kukk. Kes oli ja on Ragnar Nurkse? Ülevaade eesti soost majandusteadlase Ragnar Nurkse (1907-1959) elukäigust

The MOST - Monitor for Oxygenation of Surface and Tissue.

Science.gov (United States)

1995-10-01

anesthesia Effectiveness of COR Bio-feedback for peripheral vasodilation Relationship of CPAP and PEEP to atelectasis Waveforms Diagnosis of irregularities...deliberate hypoxia in premature infants Servo-controlled saturation, prematures Converse 02 in home 02 therapy Determine optimal PEEP and CPAP Monitor...Kusakawa I, Ohata J, Kawano T, Honma Y. Use of Pulse Oximetry In Neonatal Anesthe- sia. J Perinatology. 1987:7;343-5. Nishimura S, Tomita Y, Horiuchi T

Milleks meile Afganistan? / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2007-01-01

Afganistani sõdade ajaloost ja riigi allakäigust alates 1973. aastast, kui Daud Khan korraldas riigipöörde ja kuningas pages riigist, Nõukogude okupatsioonist 1979-1989. Afganistanis toimuvatest islami terroristide koolitustest, Talibani võimust, narko- ja relvakaubandusest, Eesti kaitseväelaste hukkumisest Afganistanis. Kaart

Doktor Haageni preparaadid / Kalev Vapper

Index Scriptorium Estoniae

Vapper, Kalev, 1982-

2008-01-01

Mõtteid ja assotsiatsioone Kaido Haageni kaks nädalat pärast pommitamist Gruusias tehtud fotoseeriat vaadates. Fotosid eksponeeriti näitusel "Seinad 080808" Disaini- ja Arhitektuurigaleriis Tallinnas

Tarand tegi Tarandit / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2011-01-01

Euroopa Parlamendi liikme Indrek Tarandi kandideerimisest Toomas Hendrik Ilvese vastaskandidaadina eelseisvatel presidendivalimistel. Vt. samas Andres G. Adamsoni karikatuur. Vt. ka lk. 4: Indrek tegi jälle Tarandit

Iraanis toimuvad presidendivalimised / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2005-01-01

Iraanis toimuvatest presidendivalimistest. Kaheksast kandidaadist on parimad väljavaated presidendiks saada endisel presidendil Akbar Hashemi Rafsanjanil ja endisel kultuuri- ja kõrgharidusministril Mustafa Moinil

Ostetud lõputööga saaks ülikoolidiplomi kätte küll / Kristi Leppik

Index Scriptorium Estoniae

Leppik, Kristi

2008-01-01

Plagiaadist, autoriõigusest ja lõputööde ostmisest ajakirjandusliku eksperimendina korraldatud õigusteaduse bakalaureuse lõputöö hankimise näitel Kommenteerivad Tallinna Tehnikaülikooli ehitusteaduskonna dekaan Roode Liias, Akadeemia Nord õigusteaduste dekaan Aare Kruuser, Tartu Ülikooli majandusteaduskonna arenduspordekaan Jüri Sepp, Tallinna Ülikooli riigireaduste instituudi direktor Leif Kalev

Short outlines of books by Estonian authors / Janika Kronberg and Rutt Hinrikus

Index Scriptorium Estoniae

Kronberg, Janika, 1963-

2010-01-01

Arvustus: Käsper, Kalle. Buridanid. I-V. Tallinn : Eesti Keele Sihtasutus, 2005-2010 ; Kivastik, Mart. Eesti asjad. Tartu : Kaks Musketäri, 2010 ; Kangro, Maarja. Ahvid ja solidaarsus. Tallinn : Eesti keele Sihtasutus, 2010 ; Põder, Rein. Unustatud. Tallinn : Eesti Raamat, 2010 ; Kesküla, Kalev. Elu sumedusest. Tallinn : Tuum, 2009 ; Pilv, Aare. Ramadaan. Tallinn : Tuum, 2010

[Alveolar ventilation and recruitment under lung protective ventilation].

Science.gov (United States)

Putensen, Christian; Muders, Thomas; Kreyer, Stefan; Wrigge, Hermann

2008-11-01

Goal of mechanical ventilation is to improve gas exchange and reduce work of breathing without contributing to further lung injury. Besides providing adequate EELV and thereby arterial oxygenation PEEP in addition to a reduction in tidal volume is required to prevent cyclic alveolar collapse and tidal recruitment and hence protective mechanical ventilation. Currently, there is no consensus if and if yes at which price alveolar recruitment with high airway pressures should be intended ("open up the lung"), or if it is more important to reduce the mechanical stress and strain to the lungs as much as possible ("keep the lung closed"). Potential of alveolar recruitment differs from patient to patient but also between lung regions. Potential for recruitment depends probably more on regional lung mechanics - especially on lung elastance - than on the underlying disease. Based on available data neither high PEEP nor other methods used for alveolar recruitment could demonstrate a survival benefit in patients with ARDS. These results may support an individualized titration of PEEP or other manoeuvres used for recruitment taking into consideration the regional effects. Bedside imaging techniques allowing titration of PEEP or other manoeuvres to prevent end-expiratory alveolar collapse (tidal recruitment) and inspiratory overinflation may be a promising development.

Effects of positive end expiratory pressure administration during non-invasive ventilation in patients affected by amyotrophic lateral sclerosis: A randomized crossover study.

Science.gov (United States)

Crescimanno, Grazia; Greco, Francesca; Arrisicato, Salvo; Morana, Noemi; Marrone, Oreste

2016-10-01

No studies have evaluated the impact of different settings of non-invasive ventilation (NIV) in patients affected by amyotrophic lateral sclerosis (ALS). We explored consequences of positive end-expiratory pressure (PEEP) application on effectiveness of ventilation, sleep architecture and heart rate variability (HRV) in patients with ALS naïve to ventilatory treatment. In two consecutive nights, 25 patients received in random order 0 or 4 cm H2 0 of PEEP during nocturnal NIV administration (Idea Ultra ResMed) with the same level of total positive inspiratory pressure. Polysomnographies were performed to evaluate sleep and NIV quality, as well as HRV. HRV was analyzed on 4-h periods and on 5-min segments of stable NREM sleep. We did not observe differences in gas exchanges during NIV with and without PEEP. Conversely, during PEEP application increases in leaks (41.4 ± 29.3% vs 31.0 ± 25.7%, P = 0.0007) and in autotriggerings (4.2 (IQR 1.3-10.0) vs 0.9 (IQR 0.0-3.0) events/h, P NIV was associated with worse NIV and sleep quality and with higher sympathetic activity. © 2016 Asian Pacific Society of Respirology.

Obesity does not influence the onset and offset of sevoflurane effect as measured by the hysteresis between sevoflurane concentration and bispectral index.

Science.gov (United States)

Cortínez, Luis I; Gambús, Pedro; Trocóniz, Iñaki F; Echevarría, Ghislaine; Muñoz, Hernán R

2011-07-01

The onset and offset of action of anesthetic gases might be delayed by respiratory changes and gas exchange alterations present in obese patients. In this study, we assessed the influence of obesity on the hysteresis between sevoflurane and its effect as measured by the bispectral index (BIS). Because the use of positive end-expiratory pressure (PEEP) in obese patients has improved gas exchange, we also assessed the influence of PEEP on hysteresis. Fifteen obese and 15 normal-weight patients, ASA physical status I and II, 20 to 50 years old, scheduled to undergo general anesthesia for elective laparoscopic surgery, were prospectively studied. Anesthesia was induced with propofol and maintained with sevoflurane and fentanyl. At the end of surgery and after stable BIS values of 60 to 65, the inspired concentration of sevoflurane was increased to 5 vol% for 5 minutes or until BIS was rate constant was not influenced by body mass index or PEEP (P > 0.05). Neither obesity nor PEEP showed any influence on the PK/PD descriptors. Our results do not support the hypothesis that obesity prolongs induction or recovery times when sevoflurane, a poorly soluble anesthetic, is used to maintain anesthesia from 90 to 120 minutes.

Poliitikute soodsad majaostud jätavad jõuministrid külmaks / Tuuli Koch, Priit Rajalo

Index Scriptorium Estoniae

Koch, Tuuli

2005-01-01

Peaminister Andrus Ansipi ja justiitsministri Rein Langi suhtumisest majandusminister Edgar Savisaare Keila-Joa krundi ostusse. 500 000 krooni eest ostis kinnistu Keila-Joal ka ärimees Raimo Kägule kuuluv firma OÜ Marriot. Lisa: Savisaare küsitavad tehingud. Vt. samas: Politseimaja rent toob Oliver Kruudale miljoneid. Kommenteerib ASi Kalev Real Estate Company nõukogu liige Oliver Kruuda

Kultuurkapital nimetas aasta parimad

Index Scriptorium Estoniae

2011-01-01

Eesti Kultuurkapitali aastapreemia 2010 laureaadid: arhitektid Maarja Kask, Ralf Lõoke, Karli Luik (Sõmeru keskusehoone), animaator Mati Kütt (Taevalaul), helilooja Urmas Sisask, kirjanik Mats Traat (Minge üles mägedele), sporditreener Anna Levandi, kunstnik Denes Kalev Farkas (Let's Play, the Game Is Over), teatriühendus R.A.A.A.M., folklorist Anu Korb (Eesti asundused)

Ideed, mis muudavad maailma

Index Scriptorium Estoniae

2012-01-01

Noorte ettevõtluskonkursi Ajujaht finalistidest: Richard Murutar (Dolphin), Andrus Purde (Achoo), Kalev Külaase, Ülane Vilumets, Rait Kapp (Kohalik Giid), Mart Raus, Vahur Mäe (Grillcube), Dmitri Kuznetsov, Anna Agronova, Julia Abolina, Anatoly Loginov (Healthiest.mobi), Karin Juhe, Karin Aruots (Korsid), Raino Sinisalu, Märt Pikkani, Arkadi Tammik, Varje Papp (Raybike), Egle Loit, Kair Käsper (Pille toidukott)

Indigolapsed - teistmoodi lapsed või lihtsalt lapsed? / Katrin Helend-Aaviku

Index Scriptorium Estoniae

Helend-Aaviku, Katrin

2009-01-01

Juuru rahvamajas näidati filmiõhtul James Twymani indigolastest rääkivat dokumentaalfilmi "Indigo evolutsioon" (USA, 2005). Filmi ning Lee Carrolli ja Jan Toberi raamatu "Indigolapsed: uus põlvkond on saabunud" põhjal järgnenud arutelust indigolastest koos psühholoog Pille Kuldkepi ja Kalev Veskimäega, kellel on soov luua Paidesse vabakool

Barbarid, plastiliinijänes, Miriam ja Frank Muller / Annika Koppel

Index Scriptorium Estoniae

Koppel, Annika

2003-01-01

Nukufilm näitab 4 uut filmi : "Barbarid" (stsenaristid Andrus Kivirähk ja Hardi Volmer, režissöör H. Volmer), "Porgand" (stsenarist Peep Pedmanson, režissöör Pärtel Tall), "Miriami jõulupäkapikk" (stsenaristid Leelo Tungal ja Peep Pedmanson, režissöör Mait Laas), "Kuuvaatleja" (reklaamitreiler Frank Mulleri kellafirmale ; stsenarist, režissöör, kunstnik Mati Kütt)

Avaliação da função pulmonar de recém-nascidos com síndrome do desconforto respiratório em diferentes pressões finais expiratórias positivas Assessment of pulmonary function of preterm newborn infants with respiratory distress syndrome at different positive end expiratory pressure levels

Directory of Open Access Journals (Sweden)

Luiz C.T. Consolo

2002-09-01

Full Text Available RESUMO\tABSTRACT \t Objetivo: verificar as alterações da função pulmonar: complacência dinâmica (Cdyn, volume corrente inspiratório (V Tinsp, pressão arterial de dióxido de carbono (PaCO2, em recém-nascidos pré-termo com síndrome do desconforto respiratório. Pacientes e Métodos: estudo de caso controle, incluindo 11 pré-termos com idade gestacional Objective: to verify the alterations of pulmonary function in preterm newborn infants with respiratory distress syndrome (RDS. The parameters analyzed were Dynamic Compliance (Cdyn, Inspiratory Tidal Volume (TVinsp, partial arterial pressure of carbon dioxide (PaCO2. Methods: eleven preterm newborn infants, with gestational age < 35 weeks, and birth weight < 2.500 g, were include in a control case study. All infants presented RDS and were treated with 120 mg/Kg of porcine surfactant. The initial positive end expiratory pressure (PEEP was 3 cm H2O. A pneumotachograph with a graphical monitor was used to assess the pulmonary function. After each increase in the PEEP (4 and 6 cm H2O, there was an interval of 20 minutes before measuring the arterial data of pulmonary function and arterial gases. Results: there were three males and eight females (1:2,7 among the infants with RDS. The mean gestational age was 30.78. 2.05 weeks, ranging from 26 to 34 weeks. The increase in the PEEP from 3 to 6 cm H2O caused significant decrease in the TVinsp (6.46 ±3.43 to 4.20 ±2.35, P=0.0262. With the increase in the PEEP from 4 to 6 cm H2O, there was also a decrease in the TVinsp (5.98.± 3.33 to 4.20.± 2.35, (P=0.0044. Regarding the Cdyn, when there was an increase in the PEEP from 3 to 6 cm H2O, the reduction was statistically significant (0.58.± 0.27 to 0.46± 0.25, P=0.0408 and from 4 to 6 cm H2O, the reduction in the Cdyn was also important (0.77± 0.27 to 0.46± 0.25, (P=0.0164. Increases in the PEEP from 4 to 6 cm H2O caused increases in the PaCO2 (52.81± 15.49 to 64.90± 12.69, (P= 0,0141. A

Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis.

Science.gov (United States)

Guo, Lei; Wang, Weiwei; Zhao, Nana; Guo, Libo; Chi, Chunjie; Hou, Wei; Wu, Anqi; Tong, Hongshuang; Wang, Yue; Wang, Changsong; Li, Enyou

2016-07-22

It has been shown that the application of a lung-protective mechanical ventilation strategy can improve the prognosis of patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). However, the optimal mechanical ventilation strategy for intensive care unit (ICU) patients without ALI or ARDS is uncertain. Therefore, we performed a network meta-analysis to identify the optimal mechanical ventilation strategy for these patients. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, EMBASE, MEDLINE, CINAHL, and Web of Science for studies published up to July 2015 in which pulmonary compliance or the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FIO2) ratio was assessed in ICU patients without ALI or ARDS, who received mechanical ventilation via different strategies. The data for study characteristics, methods, and outcomes were extracted. We assessed the studies for eligibility, extracted the data, pooled the data, and used a Bayesian fixed-effects model to combine direct comparisons with indirect evidence. Seventeen randomized controlled trials including a total of 575 patients who received one of six ventilation strategies were included for network meta-analysis. Among ICU patients without ALI or ARDS, strategy C (lower tidal volume (VT) + higher positive end-expiratory pressure (PEEP)) resulted in the highest PaO2/FIO2 ratio; strategy B (higher VT + lower PEEP) was associated with the highest pulmonary compliance; strategy A (lower VT + lower PEEP) was associated with a shorter length of ICU stay; and strategy D (lower VT + zero end-expiratory pressure (ZEEP)) was associated with the lowest PaO2/FiO2 ratio and pulmonary compliance. For ICU patients without ALI or ARDS, strategy C (lower VT + higher PEEP) was associated with the highest PaO2/FiO2 ratio. Strategy B (higher VT + lower PEEP) was superior to the other strategies in improving pulmonary

Investigation of continuous effect modifiers in a meta-analysis on higher versus lower PEEP in patients requiring mechanical ventilation--protocol of the ICEM study.

Science.gov (United States)

Kasenda, Benjamin; Sauerbrei, Willi; Royston, Patrick; Briel, Matthias

2014-05-20

Categorizing an inherently continuous predictor in prognostic analyses raises several critical methodological issues: dependence of the statistical significance on the number and position of the chosen cut-point(s), loss of statistical power, and faulty interpretation of the results if a non-linear association is incorrectly assumed to be linear. This also applies to a therapeutic context where investigators of randomized clinical trials (RCTs) are interested in interactions between treatment assignment and one or more continuous predictors. Our goal is to apply the multivariable fractional polynomial interaction (MFPI) approach to investigate interactions between continuous patient baseline variables and the allocated treatment in an individual patient data meta-analysis of three RCTs (N = 2,299) from the intensive care field. For each study, MFPI will provide a continuous treatment effect function. Functions from each of the three studies will be averaged by a novel meta-analysis approach for functions. We will plot treatment effect functions separately for each study and also the averaged function. The averaged function with a related confidence interval will provide a suitable basis to assess whether a continuous patient characteristic modifies the treatment comparison and may be relevant for clinical decision-making. The compared interventions will be a higher or lower positive end-expiratory pressure (PEEP) ventilation strategy in patients requiring mechanical ventilation. The continuous baseline variables body mass index, PaO2/FiO2, respiratory compliance, and oxygenation index will be the investigated potential effect modifiers. Clinical outcomes for this analysis will be in-hospital mortality, time to death, time to unassisted breathing, and pneumothorax. This project will be the first meta-analysis to combine continuous treatment effect functions derived by the MFPI procedure separately in each of several RCTs. Such an approach requires individual

Effects of positive end-expiratory pressure on renal function.

Science.gov (United States)

Järnberg, P O; de Villota, E D; Eklund, J; Granberg, P O

1978-01-01

The effects were studied positive end-expiratory pressure (PEEP) on renal function in eight patients with acute respiratory failure, requiring mechanical ventilation. On application of PEEP + 10 cm H2O, central venous pressure increased, systolic blood pressure decreased, urine flow and PAH-clearance were reduced, while inulin clearance remained stable. There was a marked increase in fractional sodium reabsorption and a concurrent decrease in fractional osmolal excretion. Fractional free-water clearance and the ratio UOsm/POsm did change.

Positional effects on distribution of ventilation in chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Shim, C.; Chun, K.J.; Williams, M.H. Jr.; Blaufox, M.D.

1986-01-01

Ventilation is distributed predominantly to the dependent lung in normal persons in the decubitus position. We evaluated the distribution of ventilation in four patients with mild-to-moderate chronic obstructive pulmonary disease using 81mKr gas. Patients were tested in the sitting and right and left decubitus positions with and without the application of positive end expiratory pressure (PEEP). In contrast to findings in controls, ventilation was predominantly distributed to the nondependent lung in patients in the decubitus position. Mean ventilation in the right lung decreased from 51% of the total in the sitting position to 31% in the right decubitus position; it increased with the application of 10 cm PEEP. Reduced ventilation in the dependent lung most likely is caused by closure of the airways after a decrease in volume. Application of PEEP resulted in increased lung volume and preferential distribution of ventilation to the dependent lung

Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data.

Science.gov (United States)

Neto, Ary Serpa; Hemmes, Sabrine N T; Barbas, Carmen S V; Beiderlinden, Martin; Fernandez-Bustamante, Ana; Futier, Emmanuel; Gajic, Ognjen; El-Tahan, Mohamed R; Ghamdi, Abdulmohsin A Al; Günay, Ersin; Jaber, Samir; Kokulu, Serdar; Kozian, Alf; Licker, Marc; Lin, Wen-Qian; Maslow, Andrew D; Memtsoudis, Stavros G; Reis Miranda, Dinis; Moine, Pierre; Ng, Thomas; Paparella, Domenico; Ranieri, V Marco; Scavonetto, Federica; Schilling, Thomas; Selmo, Gabriele; Severgnini, Paolo; Sprung, Juraj; Sundar, Sugantha; Talmor, Daniel; Treschan, Tanja; Unzueta, Carmen; Weingarten, Toby N; Wolthuis, Esther K; Wrigge, Hermann; Amato, Marcelo B P; Costa, Eduardo L V; de Abreu, Marcelo Gama; Pelosi, Paolo; Schultz, Marcus J

2016-04-01

Protective mechanical ventilation strategies using low tidal volume or high levels of positive end-expiratory pressure (PEEP) improve outcomes for patients who have had surgery. The role of the driving pressure, which is the difference between the plateau pressure and the level of positive end-expiratory pressure is not known. We investigated the association of tidal volume, the level of PEEP, and driving pressure during intraoperative ventilation with the development of postoperative pulmonary complications. We did a meta-analysis of individual patient data from randomised controlled trials of protective ventilation during general anesthaesia for surgery published up to July 30, 2015. The main outcome was development of postoperative pulmonary complications (postoperative lung injury, pulmonary infection, or barotrauma). We included data from 17 randomised controlled trials, including 2250 patients. Multivariate analysis suggested that driving pressure was associated with the development of postoperative pulmonary complications (odds ratio [OR] for one unit increase of driving pressure 1·16, 95% CI 1·13-1·19; pprotective ventilation on development of pulmonary complications (p=0·027). In two studies that compared low with high PEEP during low tidal volume ventilation, an increase in the level of PEEP that resulted in an increase in driving pressure was associated with more postoperative pulmonary complications (OR 3·11, 95% CI 1·39-6·96; p=0·006). In patients having surgery, intraoperative high driving pressure and changes in the level of PEEP that result in an increase of driving pressure are associated with more postoperative pulmonary complications. However, a randomised controlled trial comparing ventilation based on driving pressure with usual care is needed to confirm these findings. None. Copyright © 2016 Elsevier Ltd. All rights reserved.

Karl Kello - elukutse olla saarlane / Aare Laine

Index Scriptorium Estoniae

Laine, Aare, 1951-

2004-01-01

Kuressaare Kuursaalis näidati kadripäeval nelja Ruta Celma ja Karl Kello kultuuriloolist dokumentaalfilmi : "Narr Jumala kojas" (2000), "Phaetonit otsides" (1999), "Eestlased Lätis" (2004) ja Kalevipoja temaatikat arendav "Küll siis Kalev..." (2004). Filmide operaator on Arvo Vilu. Artikli autor kõneleb Karl Kellost, tema Karja kiriku ja Kaali järve problemaatika arendustest peale filmide ka kirjasõnas

The President and the Intelligence Community: The Importance of the Relationship

Science.gov (United States)

2017-12-01

Intelligence Successes and Failures in Operations Desert Shield/Storm, (Washington, DC: Government Printing Office, 1993), 2–3, http://www.dtic.mil... Intelligence as Leaders of the U.S. Intelligence Community 1946–2005. Washington, D.C.: Government Printing Office, 2005. Hedley, John Hollister...THE INTELLIGENCE COMMUNITY: THE IMPORTANCE OF THE RELATIONSHIP by Dane M. Holtmeyer December 2017 Thesis Advisor: Kalev I. Sepp

Töötaja leiab ka miinimumpalgaga / Ralf-Martin Soe

Index Scriptorium Estoniae

Soe, Ralf-Martin

2007-01-01

Ilmunud ka: Delovõje Vedomosti 31. okt. lk. 6. Madalate palkade TOP 10. Vt. samas: Küsimustele vastab Helter-R-i tegevjuht Kalev Kivipalu; Madal palk toob kaela maksuameti luubi alla sattumise; Endised töötajad: Helter-R-is sain palka osaliselt sulas; Tagant teine: suur juveelitootja - keskmine palk 3400 krooni kuus; Tagant kolmas koht: maksuamet uuris väikseid palku; Tabel. Kommenteerib Ruth Laatre

Oliver Kruuda : Valitsus on loll. Riiki ei juhi keegi / Oliver Kruuda ; interv. Urmo Soonvald

Index Scriptorium Estoniae

Kruuda, Oliver, 1967-

2008-01-01

Ilmunud ka: Vesti Dnja 28. mai lk. 4. Ärimees Oliver Kruuda majandusprobleemide põhjustest Eestis, peaminister Andrus Ansipist, hüpoteegipanga rajamise vajadusest, Eesti ajakirjanduse erapoolikust suhtumisest tema ja Edgar Savisaare tegevusse, Kalevi ja Tere müümisest, Kalev Meedia asutamise ajenditest ja perspektiividest, jõukusest, võlgadest, poegade kasvatamisest. Lisad: Kuidas riigi raha säästa; Kes on Oliver Kruuda?

Iõhvi ne sobral deneg na skulpturu dudotshnika

Index Scriptorium Estoniae

2008-01-01

Jõhvi vallakunstnik Kalev Prits plaanib Jõhvi kontserdimaja juurde puu otsa paigaldada vilepillimängija skulptuuri ja kogub selleks sponsorraha. Tõenäoliselt asuvad uue skulptuuri kallal tööle läti kunstnik Edvin Kruminsh ja Aivar Simson. Kruminshi kätetöö on Jõhvi sissesõidutee ääres seisev metallist siil. Simpson on Jõhvi teinud karude ja lindude kujusid ning siilikujulisi lillepotte

Kommivabriku aura jääb Tondile. Ideid Kalevi kvartali tulevikuks / Piret Peensoo

Index Scriptorium Estoniae

Peensoo, Piret

2003-01-01

Tallinnas Järvevana tee ja Pärnu maantee vahelise ala ruumilise planeerimise ideeprojekti avalik arhitektuurikonkurss, võitjad Nikolai Volkov ja Liis Sagadi, 2. koht - Irina Raud, Toomas Tammis, Tarmo Teedumäe, Karl Luik, Renee Puusepp, 3. koht - Veronika Valk. Laste Maailma Galeriis võistlusprojektide näitus "Magus urbanism". Fakte kommivabriku "Kalev" ajaloost. Vabrik jätkab tööd Rae vallas Põrguväljal

Weimar, Euroopa kultuuripealinn / Peep Pillak

Index Scriptorium Estoniae

Pillak, Peep, 1957-

1999-01-01

1999. a. Euroopa kultuuripealinnast Weimarist. Linna minevikust, Weimaris elanud suurmehi, juubelitest, mida tähistatakse 1999. a. 1552. a. asus Weimarisse Lucas Cranach, isa alustatut jätkas Lucas Cranach noorem. 1919. a. alustas Walter Gropiuse juhtimisel Weimaris tegevust Bauhaus, kus aastatel 1922-1925 töötasid ka Wassily Kandinsky, Paul Klee

Pommisatelliit Eesti kohal / Peep Pedmanson

Index Scriptorium Estoniae

Pedmanson, Peep, 1963-

1997-01-01

Discovery Channel Europe presenteeris Pirital toimunud telemessil videofilmi "Profid. Pommirühm" ("Professionals : Bomb Squad"), stsenarist, režissöör ja operaator Rein Kotov : Inglismaa - Eesti - Taani 1997

Tarbekunstist ja kunstitarbest / Peep Ilmet

Index Scriptorium Estoniae

Ilmet, Peep, pseud., 1948-

2010-01-01

4. rahvusvahelisest köitekunsti näitusest "Scripta manent" Eesti Tarbekunsti- ja Disainimuuseumis, näituse arengust, eesti köitekunstist, autori soovitused eesti köitekunsti rikastamiseks. Raamatu sisu kaitse ja ligipääsetavuse nõudest

Kutsekeskkooli õpilaste koosseisust / Peep Leppik

Index Scriptorium Estoniae

Leppik, Peep

2001-01-01

Helme Kutsekeskkoolis 1985-1988, 1991-1992.a. läbi viidud uuringutest, milles määrati õpilaste IQ, käitumine, õppetöös edasijõudmine. Võrdluseks teisi Eesti koolide õpilaste seas läbi viidud intelligentsusuuringuid (Juhan Tork, 1939 ; Eda Heinla, 1988-1990 ; Juha Sõerd, 1973 ; A.Sukamägi, K.Tamm, 1994)

Tõde selgub võrdluses / Kalev Kotkas

Index Scriptorium Estoniae

Kotkas, Kalev, 1960-

2001-01-01

Vastukaja M. Treiali art. "Sotisaalhoolekande seaduse muudatustest", Vooremaa 11. okt. 2001, lk. 2. Autor: Rahvaerakond Mõõdukad. Parlamendisaadik. Ilmunud ka: Valgamaalane (2001) 27. okt., lk. 2 ; Põhjarannik (2001) 26. okt., lk. 2 ; Hiiu Leht (2001) 19. okt., lk. 2 ; Koit (2001) 20. okt., lk. 6 ; Meie Maa (2001) 23. okt., lk. 2

Kohus himustab Sudaani presidenti / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2009-01-01

Rahvusvaheline kirminaalkohus otsustas anda välja rahvusvahelise orderi Sudaani presidendi Omar al-Bashir vahistamiseks sõja- ja inimsusevastaste kuritegude eest. Sellekohased arvamused välisajakirjanduses

Pinochet taas trellide taga / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2005-01-01

Santiagos vahistati Tšiili endine diktaator Augusto Pinochet, keda süüdistatakse maksupettuses ja passide võltsimises seoses salajaste pangaarvetega, millel on hoiustatud miljoneid dollareid valenimede all USA-s ja teistes riikides

Ohupilved stabiilse euroraha kohal / Kalev Kallemets

Index Scriptorium Estoniae

Kallemets, Kalev, 1979-

2004-01-01

Ilmunud ka: Põhjarannik, 4. aug. 2004, lk. 2; Severnoje Poberezhje, 4. aug. 2004, lk. 2; Lääne Elu, 5. aug. 2004, lk. 2; Nädaline, 5. aug. 2004, lk. 4; Valgamaalane, 5. aug. 2004, lk. 2; Meie Maa, 5. aug. 2004, lk. 2; Koit, 5. aug. 2004, lk. 6; Vali Uudised, 6. aug. 2004, lk. 2; Hiiu Leht, 6. aug. 2004, lk. 2; Võrumaa Teataja, 7. aug. 2004, lk. 2; Harjumaa, 10. aug. 2004, lk. 2; Sakala, 11. aug. 2004, lk. 2. Euroraha stabiilsuse ohustajad

Pantvangidraama Põhja-Osseetia keskkoolis / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2004-01-01

Põhja-Osseetia piirilinnas Beslanis võeti koolimaja koos õpilaste, õpetajate ja lapsevanematega pantvangi, hõivajad nõudsid läbirääkimistele Põhja-Osseetia presidenti Aleksandr Dzassohhovit, Inguššia presidenti Murat Zjazikovi ja doktor Leonid Roshali, et nende kaudu esitada nõudmised Inguššia võimude poolt vangistatud sisside vabastamiseks. Kaart: Põhja-Osseetia

Me alles hakkame ehitama / Kalev Kallemets

Index Scriptorium Estoniae

Kallemets, Kalev, 1979-

2006-01-01

Ilmunud ka: Delovõje Vedomosti 6. dets. lk. 10. Eesti elamuehituse maht on alles jõudmas Euroopa tasemele ning selleks, et jõuaksime keskmiste eluruumi ruutmeetritega inimese kohta järele arenenud riikidele, kulub veel palju aktiivseid kinnisvara arendamise aastaid, leiab autor

Majanduskasv jätkub / Kalev Kallemets

Index Scriptorium Estoniae

Kallemets, Kalev, 1979-

2006-01-01

Reformierakonna ettepanekutest järgmisteks aastateks - tulumaksu langetamine, laenuvõtmise ergutamine, müüa või anda kasutamiseks erakätesse riigile kuuluvat kinnisvara (sh valitsemiseks mittevajalik maa), ettevõtluse arendamine

Tsirkus või demokraatia / Kalev Kallemets

Index Scriptorium Estoniae

Kallemets, Kalev, 1979-

2005-01-01

Autor leiab, et riigikontrolli suunamine kohalikesse omavalitsustesse ning justiitsminister Ken-Marti Vaheri plaan süüdistada sel aastal 63 ametnikku üle Eesti on kõigi avaliku teenistuse töötajate alandamine

Izvinite, jeshtsho raz izvinite / Raul Kalev

Index Scriptorium Estoniae

Kalev, Raul

2007-01-01

Autor selgitab eestlaste ja venelaste erinevat suhtumist Teise maailmasõja tulemustesse ning valitsuse käitumist pronkssõduri probleemi lahendamisel ja leiab, et eestlased ja venelased peavad proovima mõista teineteist, soovima tundma õppida kõrvuti elavate rahvaste ajalugu, kombeid ja pühadusi

Eestis meenutati Paul Kerest / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2011-01-01

Paul Kerese 95. sünniaastapäeva puhul viibisid Tallinnas male eksmaailmameister Anatoli Karpov ja teised malemaailma tipud. President Toomas Hendrik Ilves kohtus male suurkujudega Kadriorus 6. jaan. 2011

Relvastatud jõu kasutamine / Kalev Stoicescu

Index Scriptorium Estoniae

Stoicescu, Kalev

2006-01-01

Sõjalistes operatsioonides peavad jõu kasutamise reeglid olema piisavalt selged, nende koostamisel arvestatakse oma riigi seadusi ja rahvusvahelist õigust, kuid ka kohalikku kultuuritausta. Liiga kitsad reeglid võivad piirata sõjalise ülema tegevust, liiga laiad või ähmased reeglid aga võivad viia konflikti eskaleerumisele. Näiteid

Physiologic effects of alveolar recruitment and inspiratory pauses during moderately-high-frequency ventilation delivered by a conventional ventilator in a severe lung injury model.

Directory of Open Access Journals (Sweden)

Ricardo Luiz Cordioli

Full Text Available To investigate whether performing alveolar recruitment or adding inspiratory pauses could promote physiologic benefits (VT during moderately-high-frequency positive pressure ventilation (MHFPPV delivered by a conventional ventilator in a porcine model of severe acute respiratory distress syndrome (ARDS.Prospective experimental laboratory study with eight pigs. Induction of acute lung injury with sequential pulmonary lavages and injurious ventilation was initially performed. Then, animals were ventilated on a conventional mechanical ventilator with a respiratory rate (RR = 60 breaths/minute and PEEP titrated according to ARDS Network table. The first two steps consisted of a randomized order of inspiratory pauses of 10 and 30% of inspiratory time. In final step, we removed the inspiratory pause and titrated PEEP, after lung recruitment, with the aid of electrical impedance tomography. At each step, PaCO2 was allowed to stabilize between 57-63 mmHg for 30 minutes.The step with RR of 60 after lung recruitment had the highest PEEP when compared with all other steps (17 [16,19] vs 14 [10, 17]cmH2O, but had lower driving pressures (13 [13,11] vs 16 [14, 17]cmH2O, higher P/F ratios (212 [191,243] vs 141 [105, 184] mmHg, lower shunt (23 [20, 23] vs 32 [27, 49]%, lower dead space ventilation (10 [0, 15] vs 30 [20, 37]%, and a more homogeneous alveolar ventilation distribution. There were no detrimental effects in terms of lung mechanics, hemodynamics, or gas exchange. Neither the addition of inspiratory pauses or the alveolar recruitment maneuver followed by decremental PEEP titration resulted in further reductions in VT.During MHFPPV set with RR of 60 bpm delivered by a conventional ventilator in severe ARDS swine model, neither the inspiratory pauses or PEEP titration after recruitment maneuver allowed reduction of VT significantly, however the last strategy decreased driving pressures and improved both shunt and dead space.

T-piece resuscitators: how do they compare?

Science.gov (United States)

Hinder, Murray; McEwan, Alistair; Drevhammer, Thomas; Donaldson, Snorri; Tracy, Mark Brian

2018-05-04

The T-piece resuscitator (TPR) has seen increased use as a primary resuscitation device with newborns. Traditional TPR design uses a high resistance expiratory valve to produce positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) at resuscitation. A new TPR device that uses a dual flow ratio valve (fluidic flip) to produce PEEP/CPAP is now available (rPAP). We aimed to compare the measured ventilation performance of different TPR devices in a controlled bench test study. Single operator provided positive pressure ventilation to an incremental testlung compliance (Crs) model (0.5-5 mL/cmH 2 O) with five different brands of TPR device (Atom, Neopuff, rPAP, GE Panda warmer and Draeger Resuscitaire). At recommended peak inflation pressure (PIP) 20 cmH 2 O, PEEP of 5 cmH 2 O and rate of 60 inflations per minute. 1864 inflations were analysed. Four of the five devices tested demonstrated inadvertent elevations in mean PEEP (5.5-10.3 cmH 2 O, p<0.001) from set value as Crs was increased, while one device (rPAP) remained at the set value. Measured PIP exceeded the set value in two infant warmer devices (GE and Draeger) with inbuilt TPR at Crs of 0.5 (24.5 and 23.5 cmH 2 O, p<0.001). Significant differences were seen in tidal volumes across devices particularly at higher Crs (p<0.001). Results show important variation in delivered ventilation from set values due to inherent TPR device design characteristics with a range of lung compliances expected at birth. Device-generated inadvertent PEEP and overdelivery of PIP may be clinically deleterious for term and preterm newborns or infants with larger Crs during resuscitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Dr. Heinz von zur Mühlen - teenekas Tallinna ajaloo uurija / Peep Pillak ; foto: Peep Pillak

Index Scriptorium Estoniae

Pillak, Peep

2003-01-01

ülevaade üheks paremaks Eesti ja Liivimaa, eriti aga Tallinna keskaja asjatundjaks peetava baltisakslasest ajaloolase eluteest ja teaduslikest uurimustöödest, mille eest pälvis 11. sept. 2002 Tallinna teenetemärgi

Kto samõi bogatõi v Estonii / Sten-Aleks Pihlak, Kärt Blumberg, Lemmi Kann

Index Scriptorium Estoniae

Pihlak, Sten-Aleks

2008-01-01

Eesti laevatranspordi kolmik - Ain Hanschmidt, Enn Pant ja Kalev Järvelill on Äripäeva rikaste edetabelis esimesed. Viimaste kuude suure aktsiahinnalanguse tõttu on paljud Äripäeva rikaste edetabelis olijad kaotanud igast kolmest kroonist kaks. Artiklis selgitatakse miks on Äripäeva Rikaste TOPis vähe naisi. Lisad: Iz TOP-500 samõhh bogatõhh ljudei v Estonii; Reitingi bogatshei za prezhnije godõ; Metodika

Salapärane Boeing tõi Eestisse konteinereid / Ester Vilgats

Index Scriptorium Estoniae

Vilgats, Ester

2005-01-01

Ilmunud ka: Pärnu Postimees 8. nov., lk. 3, Postimees : na russkom jazõke 10. nov. lk. 10. Pärnu lennujaama juhataja Erki Teemägi ja Kaitsepolitsei Pärnu osakonna politseidirektor Kalev Kont kinnitasid, et Pärnu lennuväljal 12. jaanuaril 2003. aastal maandunud Boeing 737 vedas kaubakonteinereid, mitte terroristidest sõjavange, nagu väitis ajaleht Washington Post. Vt. samas: Neeme Raud. Inimõiguslased ootavad euroliidu sekkumist

Kulka kroonis aasta kümme sulesangarit / Kaarel Kressa

Index Scriptorium Estoniae

Kressa, Kaarel, 1983-

2010-01-01

Eesti Kultuurkapital kirjanduse sihtkapitali aastaauhinnad: parim ilukirjanduslik proosateos Kalev Kesküla "Elu sumedusest", parim luulekogu Hasso Krull "Neli korda neli", esseistika kogumik Jaan Kaplinski "Paralleele ja parallelisme", vabaauhind Jaan Unduski koostatud Friedebert Tuglase teoste kogumik "Valik proosat", parim lasteraamat Mika Keränen "Peidetud hõbedane aardelaegas", parimad tõlked: Piret Salurilt (Mika Waltari "Sinuhe"), Jean Pascal Ollivry Tammsaare tõlked (Veritee et Justice : La Collin-du-Voleur ; Indrek)

Aasta parimad teosed Krullilt ja Keskülalt / Heili Sibrits

Index Scriptorium Estoniae

Sibrits, Heili, 1977-

2010-01-01

Eesti Kultuurkapital kirjanduse sihtkapitali aastaauhinnad: parim ilukirjanduslik proosateos Kalev Kesküla "Elu sumedusest", parim luulekogu Hasso Krull "Neli korda neli", esseistika kogumik Jaan Kaplinski "Paralleele ja parallelisme", vabaauhind Jaan Unduski koostatud Friedebert Tuglase teoste kogumik "Valik proosat", parim lasteraamat Mika Keränen "Peidetud hõbedane aardelaegas", parimad tõlked: Piret Salurilt (Mika Waltari "Sinuhe"), Jean Pascal Ollivry Tammsaare tõlked (Veritee et Justice : La Collin-du-Voleur ; Indrek)

High tidal volume ventilation in infant mice.

Science.gov (United States)

Cannizzaro, Vincenzo; Zosky, Graeme R; Hantos, Zoltán; Turner, Debra J; Sly, Peter D

2008-06-30

Infant mice were ventilated with either high tidal volume (V(T)) with zero end-expiratory pressure (HVZ), high V(T) with positive end-expiratory pressure (PEEP) (HVP), or low V(T) with PEEP. Thoracic gas volume (TGV) was determined plethysmographically and low-frequency forced oscillations were used to measure the input impedance of the respiratory system. Inflammatory cells, total protein, and cytokines in bronchoalveolar lavage fluid (BALF) and interleukin-6 (IL-6) in serum were measured as markers of pulmonary and systemic inflammatory response, respectively. Coefficients of tissue damping and tissue elastance increased in all ventilated mice, with the largest rise seen in the HVZ group where TGV rapidly decreased. BALF protein levels increased in the HVP group, whereas serum IL-6 rose in the HVZ group. PEEP keeps the lungs open, but provides high volumes to the entire lungs and induces lung injury. Compared to studies in adult and non-neonatal rodents, infant mice demonstrate a different response to similar ventilation strategies underscoring the need for age-specific animal models.

Design and Construction of a Microcontroller-Based Ventilator Synchronized with Pulse Oximeter.

Science.gov (United States)

Gölcük, Adem; Işık, Hakan; Güler, İnan

2016-07-01

This study aims to introduce a novel device with which mechanical ventilator and pulse oximeter work in synchronization. Serial communication technique was used to enable communication between the pulse oximeter and the ventilator. The SpO2 value and the pulse rate read on the pulse oximeter were transmitted to the mechanical ventilator through transmitter (Tx) and receiver (Rx) lines. The fuzzy-logic-based software developed for the mechanical ventilator interprets these values and calculates the percentage of oxygen (FiO2) and Positive End-Expiratory Pressure (PEEP) to be delivered to the patient. The fuzzy-logic-based software was developed to check the changing medical states of patients and to produce new results (FiO2 ve PEEP) according to each new state. FiO2 and PEEP values delivered from the ventilator to the patient can be calculated in this way without requiring any arterial blood gas analysis. Our experiments and the feedbacks from physicians show that this device makes it possible to obtain more successful results when compared to the current practices.

Battery life of portable home ventilators: effects of ventilator settings.

Science.gov (United States)

Falaize, Line; Leroux, Karl; Prigent, Hélène; Louis, Bruno; Khirani, Sonia; Orlikowski, David; Fauroux, Brigitte; Lofaso, Frédéric

2014-07-01

The battery life (BL) of portable home ventilator batteries is reported by manufacturers. The aim of this study was to evaluate the effects of ventilator mode, breathing frequency, PEEP, and leaks on the BL of 5 commercially available portable ventilators. The effects of the ventilator mode (volume controlled-continuous mandatory ventilation [VC-CMV] vs pressure support ventilation [PSV]), PEEP 5 cm H2O, breathing frequency (10, 15, and 20 breaths/min), and leaks during both volume-targeted ventilation and PSV on the BL of 5 ventilators (Elisée 150, Monnal T50, PB560, Vivo 50, and Trilogy 100) were evaluated. Each ventilator was ventilated with a test lung at a tidal volume of 700 ml and an inspiratory time of 1.2 s in the absence of leaks. Switching from PSV to VC-CMV or the addition of PEEP did not significantly change ventilator BL. The increase in breathing frequency from 10 to 20 breaths/min decreased the BL by 18 ± 11% (P = .005). Leaks were associated with an increase in BL during the VC-CMV mode (18 ± 20%, P = .04) but a decrease in BL during the PSV mode (-13 ± 15%, P = .04). The BL of home ventilators depends on the ventilator settings. BL is not affected by the ventilator mode (VC-CMV or PSV) or the addition of PEEP. BL decreases with an increase in breathing frequency and during leaks with a PSV mode, whereas leaks increase the duration of ventilator BL during VC-CMV. Copyright © 2014 by Daedalus Enterprises.

Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children.

Science.gov (United States)

Tusman, Gerardo; Acosta, Cecilia M; Böhm, Stephan H; Waldmann, Andreas D; Ferrando, Carlos; Marquez, Manuel Perez; Sipmann, Fernando Suarez

2017-10-13

Atelectasis is a common finding in mechanically ventilated children with healthy lungs. This lung collapse cannot be overcome using standard levels of positive end-expiratory pressure (PEEP) and thus for only individualized lung recruitment maneuvers lead to satisfactory therapeutic results. In this short communication, we demonstrate by lung ultrasound images (LUS) the effect of a postural recruitment maneuver (P-RM, i.e., a ventilatory strategy aimed at reaerating atelectasis by changing body position under constant ventilation). Data was collected in the operating room of the Hospital Privado de Comunidad, Mar del Plata, Argentina. Three anesthetized children undergoing mechanical ventilation at constant settings were sequentially subjected to the following two maneuvers: (1) PEEP trial in the supine position PEEP was increased to 10 cmH 2 O for 3 min and then decreased to back to baseline. (2) P-RM patient position was changed from supine to the left and then to the right lateral position for 90 s each before returning to supine. The total P-RM procedure took approximately 3 min. LUS in the supine position showed similar atelectasis before and after the PEEP trial. Contrarily, atelectasis disappeared in the non-dependent lung when patients were placed in the lateral positions. Both lungs remained atelectasis free even after returning to the supine position. We provide LUS images that illustrate the concept and effects of postural recruitment in children. This maneuver has the advantage of achieving recruitment effects without the need to elevate airways pressures.

Kahtlustus: Reiljan ihkas krunti Tallinnas ja salaosalust firmas / Andrus Karnau

Index Scriptorium Estoniae

Karnau, Andrus

2007-01-01

Ilmunud ka: Postimees : na russkom jazõke, 23. okt. 2007, lk. 4. Riigiprokuratuuri neljast kahtlustusest Merko Ehituse ja selle suuromaniku Toomas Annuse suhtes: väidetav altkäemaksu lubamine Rahvaliidu endisele juhile, parlamendiliikmele Villu Reiljanile, väidetav altkäemaksu andmine maa-ameti endisele peadirektorile Kalev Kangurile, väidetav altkäemaksu andmine endisele põllumajandusministrile, parlamendiliikmele Ester Tuiksoole, T. Annuse väidetav usalduse kuritarvitamine Merko Ehituse suhtes

Juhtimisülesanne : ja kalad saavad ka kinga / Ergo Metsla ; kommenteerinud Algis Perens, Liis Luuk

Index Scriptorium Estoniae

Metsla, Ergo, 1968-

2010-01-01

Juhtimisülesanne, kus ettevõte on pärast turu kokkulanemist sattunud majanduslikesse raskustesse ning ettevõtte juhid on valiku ees, kas lõhkuda aastaid koos töötanud meeskond ja koondada töötajaid või leida firma püsimajäämiseks mõni muu variant. Lahendust otsivad konsultantsioonifirma Helvetia Balti Partnerid juhatuse esimees Algis Perens ja Kalev SPA Veekeskuse müügi- ja turundusassistent Liis Luuk

Different Techniques of Respiratory Support Do Not Significantly Affect Gas Exchange during Cardiopulmonary Resuscitation in a Newborn Piglet Model.

Science.gov (United States)

Mendler, Marc R; Maurer, Miriam; Hassan, Mohammad A; Huang, Li; Waitz, Markus; Mayer, Benjamin; Hummler, Helmut D

2015-01-01

There are no evidence-based recommendations on the use of different techniques of respiratory support and chest compressions (CC) during neonatal cardiopulmonary resuscitation (CPR). We studied the short-term effects of different ventilatory support strategies along with CC representing clinical practice on gas exchange [arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2)], hemodynamics and cerebral oxygenation. We hypothesized that in newborn piglets with cardiac arrest, use of a T-piece resuscitator (TPR) providing positive end-expiratory pressure (PEEP) improves gas exchange as measured by SaO2 during CPR as compared to using a self-inflating bag (SIB) without PEEP. Furthermore, we explored the effects of a mechanical ventilator without synchrony to CC. Thirty newborn piglets with asystole were randomized into three groups and resuscitated for 20 min [fraction of inspired oxygen (FiO2) = 0.21 for 10 min and 1.0 thereafter]. Group 1 received ventilation using a TPR [peak inspiratory pressure (PIP)/PEEP of 20/5 cm H2O, rate 30/min] with inflations interposed between CC (3:1 ratio). Group 2 received ventilation using a SIB (PIP of 20 cm H2O without PEEP, rate 30/min) with inflations interposed between CC (3:1 ratio). Group 3 received ventilation using a mechanical ventilator (PIP/PEEP of 20/5 cm H2O, rate 30/min). CC were applied with a rate of 120/min without synchrony to inflations. We found no significant differences in SaO2 between the three groups. However, there was a trend toward a higher SaO2 [TPR: 28.0% (22.3-40.0); SIB: 23.7% (13.4-52.3); ventilator: 44.1% (39.2-54.3); median (interquartile range)] and a lower PaCO2 [TPR: 95.6 mm Hg (82.1-113.6); SIB: 100.8 mm Hg (83.0-108.0); ventilator: 74.1 mm Hg (68.5-83.1); median (interquartile range)] in the mechanical ventilator group. We found no significant effect on gas exchange using different respiratory support strategies

Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation.

Science.gov (United States)

Cruces, Pablo; González-Dambrauskas, Sebastián; Quilodrán, Julio; Valenzuela, Jorge; Martínez, Javier; Rivero, Natalia; Arias, Pablo; Díaz, Franco

2017-10-06

Analysis of respiratory mechanics during mechanical ventilation (MV) is able to estimate resistive, elastic and inertial components of the working pressure of the respiratory system. Our aim was to discriminate the components of the working pressure of the respiratory system in infants on MV with severe bronchiolitis admitted to two PICU's. Infants younger than 1 year old with acute respiratory failure caused by severe bronchiolitis underwent neuromuscular blockade, tracheal intubation and volume controlled MV. Shortly after intubation studies of pulmonary mechanics were performed using inspiratory and expiratory breath hold. The maximum inspiratory and expiratory flow (QI and QE) as well as peak inspiratory (PIP), plateau (PPL) and total expiratory pressures (tPEEP) were measured. Inspiratory and expiratory resistances (RawI and RawE) and Time Constants (K TI and K TE ) were calculated. We included 16 patients, of median age 2.5 (1-5.8) months. Bronchiolitis due to respiratory syncytial virus was the main etiology (93.8%) and 31.3% had comorbidities. Measured respiratory pressures were PIP 29 (26-31), PPL 24 (20-26), tPEEP 9 [8-11] cmH2O. Elastic component of the working pressure was significantly higher than resistive and both higher than threshold (tPEEP - PEEP) (P mechanics of infants with severe bronchiolitis receiving MV shows that the elastic component of the working pressure of the respiratory system is the most important. The elastic and resistive components in conjunction with flow profile are characteristic of restrictive diseases. A better understanding of lung mechanics in this group of patients may lead to change the traditional ventilatory approach to severe bronchiolitis.

Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

Science.gov (United States)

Garnier, M; Quesnel, C; Fulgencio, J-P; Degrain, M; Carteaux, G; Bonnet, F; Similowski, T; Demoule, A

2015-07-01

Independent bench studies using specific ventilation scenarios allow testing of the performance of ventilators in conditions similar to clinical settings. The aims of this study were to determine the accuracy of the latest generation ventilators to deliver chosen parameters in various typical conditions and to provide clinicians with a comprehensive report on their performance. Thirteen modern intensive care unit ventilators were evaluated on the ASL5000 test lung with and without leakage for: (i) accuracy to deliver exact tidal volume (VT) and PEEP in assist-control ventilation (ACV); (ii) performance of trigger and pressurization in pressure support ventilation (PSV); and (iii) quality of non-invasive ventilation algorithms. In ACV, only six ventilators delivered an accurate VT and nine an accurate PEEP. Eleven devices failed to compensate VT and four the PEEP in leakage conditions. Inspiratory delays differed significantly among ventilators in invasive PSV (range 75-149 ms, P=0.03) and non-invasive PSV (range 78-165 ms, Pventilation algorithms efficiently prevented the decrease in pressurization capacities and PEEP levels induced by leaks in, respectively, 10 and 12 out of the 13 ventilators. We observed real heterogeneity of performance amongst the latest generation of intensive care unit ventilators. Although non-invasive ventilation algorithms appear to maintain adequate pressurization efficiently in the case of leakage, basic functions, such as delivered VT in ACV and pressurization in PSV, are often less reliable than the values displayed by the device suggest. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Estimation of lung volume and pulmonary blood volume from radioisotopic images

International Nuclear Information System (INIS)

Kanazawa, Minoru

1989-01-01

Lung volume and pulmonary blood volume in man were estimated from the radioisotopic image using single photon emission computed tomography (SPECT). Six healthy volunteers were studied in a supine position with normal and altered lung volumes by applying continuous negative body-surface pressure (CNP) and by positive end-expiratory pressure (PEEP). 99m Tc labeled human serum albumin was administered as an aerosol to image the lungs. The CNP caused the diaphragm to be lowered and it increased the mean lung tissue volume obtained by SPECT from 3.09±0.49 l for baseline to 3.67±0.62 l for 10 cmH 2 O (p 2 O (p 2 O), respectively. The PEEP also increased the lung tissue volume to 3.68±0.68 l for 10 cmH 2 O as compared with the baseline (p 2 O PEEP. The lung tissue volume obtained by SPECT showed a positive correlation with functional residual capacity measured by the He dilution method (r=0.91, p 99m Tc-labeled red blood cells. The L/H ratio decreased after either the CNP or PEEP, suggesting a decrease in the blood volume per unit lung volume. However, it was suggested that the total pulmonary blood volume increased slightly either on the CNP (+7.4% for 10 cmH 2 O, p 2 O,p<0.05) when we extrapolated the L/H ratio to the whole lungs by multiplying the lung tissue volume obtained by SPECT. We concluded that SPECT could offer access to the estimation of lung volume and pulmonary blood volume in vivo. (author)

Influencia del reclutamiento alveolar sobre los efectos del surfactante exógeno Influence of pulmonary recruitment on exogenous surfactant effects

Directory of Open Access Journals (Sweden)

Néstor R. Herrera

2006-02-01

Full Text Available Se investigaron los efectos producidos por una maniobra de insuflación sostenida previa a la administración de surfactante exógeno y los producidos por diferentes patrones ventilatorios sobre la respuesta al mismo. Se estudiaron 20 ratas albinas adultas a las que se les produjo una injuria pulmonar por repetidos lavados con solución fisiológica. Se evaluó el pH, PaO2, PaCO2, la presión arterial sistólica, la compliance toracopulmonar y la histología. Los animales se dividieron en 2 grupos según se les hubiera aplicado o no insuflación sostenida para evaluar el efecto inmediato de la misma. Posteriormente los grupos citados fueron subdivididos en función de la capacidad residual funcional (CRF aplicada, quedando conformados 4 grupos experimentales. El grupo 1 recibió previo al surfactante una insuflación sostenida de 30 cm H2O durante 15 segundos y se ventiló posteriormente con presión al final de la espiración (PEEP de10 cm H2O. El grupo 2, no recibió insuflación sostenida y se ventiló con PEEP 10 cm H2O. El grupo 3, recibió insuflación sostenida y se ventiló con PEEP 4 cm H2O y el grupo 4, sin insuflación sostenida se ventiló con PEEP 4 cm H2O. Los efectos inmediatos del surfactante no fueron modificados por la aplicación previa de insuflación sostenida. Se verificó durante el transcurso de la experiencia un aumento de la PaO2 asociada al aumento de la capacidad residual funcional (Grupo1 p=0.0001; Grupo2 p= 0.0001, e independiente de la insuflación sostenida. El uso de insuflación sostenida previo a la administración de surfactante sumado a la ventilación con capacidad residual funcional alta se asoció con infiltración de polimorfonucleares debajo del epitelio bronquiolar (p = 0.008. Nuestros resultados no avalan el uso de insuflación sostenida previo a la administración de surfactante exógeno.An experimental modelwas devised to study the effects of a sustained insufflation maneuver on the immediate

Teenistuspüstolid valikusõelal / Ants Kalev

Index Scriptorium Estoniae

Kalev, Ants

2004-01-01

15.-16. juunil 2004 korraldatud Maksu- ja Tolliameti töötajate uute teenistusrelvade valikukonkursile esitatud püstolimudelite Walter'i P99, Sig Sauer'i Sig PRO SP 2022 ja Heckler'i ja Koch'i P 2000 näitajate kirjeldused. Valiku tegemisel Walter'i P 99 kasuks sai määravaks tootja pakutav hind ja relvastusspetsialistide arvamus

Laps vajab veel riigi toetust / Kalev Kotkas

Index Scriptorium Estoniae

Kotkas, Kalev, 1960-

2001-01-01

Ilmunud ka: Virumaa Teataja, 5. sept. 2001, lk. 7; Meie Maa, 5. sept. 2001, lk. 4; Lääne Elu, 6. sept. 2001. lk. 4; Valgamaalane, 6. sept. 2001, lk. 2; Koit, 6. sept. 2001, lk. 6; Nädaline, 13. sept. 2001, lk. 4; Vooremaa, 20. sept. 2001, lk. 4; Sakala, 26. sept. 2001, lk. 2; Järva Teataja, 27. sept. 2001, lk. 2. Lastega perede toetamisest. Autor: Rahvaerakond Mõõdukad. Parlamendisaadik

Kommunistlik Vietnam loodab suurele tulevikule / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2006-01-01

Ilmunud ka: Hiiu Leht 7. juuli lk. 4. Vietnami Kommunistliku Partei X kongressil peeti kõige tähtsamakas riigi siseprobleemidega tegelemist, mille tulemusena vahetusid president, peaminister ja Rahvuskogu esimees

Üliõpilasteatrid - teistmoodi teater / Kalev Kudu

Index Scriptorium Estoniae

Kudu, Kalev, 1961-

2007-01-01

Üliõpilasteatrite VI maailmakongressist 21. - 26. juulini Urbinos Itaalias. Autor oma ettekandest teemal "Üliõpilasteater kui mäss. Üliõpilasteatrite eriline missioon globaliseeruvas maailmas". Lühiintervjuu Liege'i ülikooli professori, üliõpilasteatri kunstilise juhi ja Rahvusvahelise Üliõpilasteatrite Liidu (AITU) esimehe Robert Germayga. Etendustest: "Shahrazad - neitsi Bagdadist" (Bologna ülikool, Itaalia"), "Mbomo-mvet" (Yaounde ülikool, Kamerun), "The Believed Dead" (Brescia Katoliiklik Ülikool, Itaalia), "Teenrid" (Teatro Verga, Milano ülikool, Itaalia), "Antigone" (Ateena ülikool, Kreeka), "Tilt!" (Teatro Aenigma, Urbino ülikool, Itaalia), "Paroodia" (Milano ja Urbino ülikoolide üliõpilased), "Erose tiivad" (Saloniki ülikool, Kreeka), "Kolmas laps" (Long Islandi ülikool, USA), "Lee-Oki lugu" (Hoseo ülikool, Lõuna-Korea), "Ülikond" (Vilniuse Tehnikaülikool, Leedu)

Tänavused mõjukamad valimised / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2004-01-01

Ilmunud ka: Meie Maa, 2. nov. 2004, lk. 4. Ameerika Ühendriikides toimuvatest presidendivalimistest, kus otsustavaks kujuneb kahe kandidaadi, George Walker Bushi ja John Forbes Kerry, vaheline heitlus

Kuningas on surnud! Elagu kuningas! / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2005-01-01

Ilmunud ka: Meie Maa 10. august lk. 5. Maailma suurima monarhistliku ja ühe suurema islamiriigi Saudi Araabia uueks kuningaks sai traditsiooniliste tavade järgi peale kuningas Fahdi surma tema poolvend Abdullah. Lisa: Saudi Araabia kuningad

A demographic outline / Kalev Katus, Allan Puur

Index Scriptorium Estoniae

Katus, Kalev, 1955-2008

2002-01-01

Ajalooline ülevaade Eesti elanikkonna kujunemisest ning Eestit läbinud migratsioonivoogudest Nõukogude okupatsiooni perioodil, mis on suuresti mõjutanud Eesti tänast demograafilist olukorda. Tabel ja diagrammid: Eestlaste ja välismaalaste arv Eestis 1922-2000; Välismaalaste osakaal Eestis päritolumaa järgi; Rahvusvahelised migratsioonivood Eestis 1946-1999; Välismaalaste osakaal valitud Euroopa riikides. Kaart.

Kulka lemmikud 2007 / Kalev Kesküla

Index Scriptorium Estoniae

Kesküla, Kalev, 1959-2010

2008-01-01

Eesti Kultuurikapitali aastapreemia said 17. saj. Tartu juhuluule kogumiku "O Dorpat, urbs addictissima musis" koostajad Kristi Viiding, Jana Orion, Janika Päll (Tallinn : Eesti Keele Sihtasutus, 2007)

Rahvusvaheliselt tõsiseltvõetav partner / Leif Kalev

Index Scriptorium Estoniae

Kalev, Leif, 1976-

2000-01-01

Eesti Üliõpilaskondade Liidu osalusest Euroopa üliõpilaskondade liitude katusühenduse (ESIB-The National Unions of Students in Europe) kui majandusliku ISIC-kaardi väljaandjate keskühenduse (ISTC-International Student Travel Association) töös. ESIB-i poolaastakoosolekul Genfis oktoobri lõpul võeti vastu avaldused Eesti, Austria ja Suurbritannia üliõpilaskondade liitude toetuseks tegevuses õppemaksude vastu. Septembri lõpul toimus Düsseldorfis rahvusvaheline noorte ja tudengite iga-aastane turismikonverents

Uue paradigma poole monumendikeskustelus / Priit-Kalev Parts

Index Scriptorium Estoniae

Parts, Priit-Kalev, 1972-

2007-01-01

Autor püstitab küsimuse, kas on üldse sünnis luua igavesi ja muutumatuid vorme. Paindlikumat tõlgendamist võimaldab näiteks muutlik ja hävinev puu, mida võib vesta või istutada. Pingemaandajana sobiks tordist monumendikoopia

Mittetulundusorganisatsioonide tegevus ja strateegiline juhtimine / Kalev Stoicescu

Index Scriptorium Estoniae

Stoicescu, Kalev

2002-01-01

Bibliogr. lk. 114. - Kokkuvõte ingl. k. lk. 115. Üleminek teadlikule ja sihikindlale strateegilisele juhtimisele teostub mittetulundusorganisatsioonis reeglina siis, kui organisatsioon on saavutanud teatud arengutaseme ehk kriitiliste ressursside massi, mis annab paremaid tegutsemisvõimalusi

Surmanuhtlus - õiglane või mitte / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2007-01-01

Artiklis käsitletakse küsimust, kas surmanuhtlust pidada õiglaseks karistuseks või pole selle täitmine demokraatlikus ühiskonnas küllaldaselt õigustatud. Ilmunud ka Meie Maa : Nädalalõpp 19-20. jaan. 2007, lk. 3

IFLA 39. aastakongress Baltimaades / Peep Moorast

Index Scriptorium Estoniae

Moorast, Peep

2002-01-01

Rahvusvaheline maastikuarhitektide föderatsiooni IFLA 39. kongress deviisiga "Muutused maastikus" Baltimaades 7.-13. X 2002. Kongressi peakorterist Riias korraldati väljasõite Lätisse, Eestisse ja Leetu. Eesti Põllumajandusülikoolis sümpoosionil esinesid Eestist Tiina Tammet ja Peeter Vassiljev. Eestile esitati kutse astuda IFLA liikmeks

Mälestustahvel Oslo valitsusele / Peep Pillak

Index Scriptorium Estoniae

Pillak, Peep, 1957-

2016-01-01

Otsustati tähistada Oslos asuv hoone, kus 1953. aastal nimetati ametiise Eesti Vabariigi valitsus eksiilis. Sõjajärgsetel aastatel organiseerusid eestlased Rootsis. Kuna Rootsis oli pagulaste poliitiline tegevus keelatud, siis toimus eksiilvalitsuse ametisse määramine Oslos. Kui 20. augustil 1991 taastati iseseisev Eesti riik, siis tunnustas seda ka Eesti Vabariigi valitsus eksiilis. Vabariigi valitsus eksiilis lõpetas oma tegevuse 7. oktoobril 1992. aastal. 2. oktoobril 2015 toimunud mälestustahvli avamisest

Andmekaitseõigusest andmekaitseasutuse pilguga / Peep Viljar

Index Scriptorium Estoniae

Peep, Viljar, 1970-

2018-01-01

Euroopa Liidu ja USA andmekaitseõiguse alusvalikute võrdlus, selgitatakse, millele keskendudb Eesti Andmekaitse Inspektsioon oma töös, andmekaitse üldmääruse trahvide regulatsioonist ja sellega seotud probleemidest Eestis

Privacy : Plug the Internet Peep Hole

OpenAIRE

Denebo, Petra; Linder, Anna-Katrine

2001-01-01

The Internet is a relatively new technology that has developed explosively during the last 10 years. The Internet-technology has been accepted rapidly by users, but the legal and ethical aspects have not been updated at the same rapid rate. Trust in electronic services or products is founded on knowledge and an understanding of what happens during a session and of the effects that might occur. Within electronically based services there are obvious risks for invisible and undesired results suc...

Mitogen-activated protein kinase phosphatase-1 modulates regional effects of injurious mechanical ventilation in rodent lungs.

Science.gov (United States)

Park, Moo Suk; He, Qianbin; Edwards, Michael G; Sergew, Amen; Riches, David W H; Albert, Richard K; Douglas, Ivor S

2012-07-01

Mechanical ventilation induces heterogeneous lung injury by mitogen-activated protein kinase (MAPK) and nuclear factor-κB. Mechanisms regulating regional injury and protective effects of prone positioning are unclear. To determine the key regulators of the lung regional protective effects of prone positioning in rodent lungs exposed to injurious ventilation. Adult rats were ventilated with high (18 ml/kg, positive end-expiratory pressure [PEEP] 0) or low Vt (6 ml/kg; PEEP 3 cm H(2)O; 3 h) in supine or prone position. Dorsal-caudal lung mRNA was analyzed by microarray and MAPK phosphatases (MKP)-1 quantitative polymerase chain reaction. MKP-1(-/-) or wild-type mice were ventilated with very high (24 ml/kg; PEEP 0) or low Vt (6-7 ml/kg; PEEP 3 cm H(2)O). The MKP-1 regulator PG490-88 (MRx-108; 0.75 mg/kg) or phosphate-buffered saline was administered preventilation. Injury was assessed by lung mechanics, bronchioalveolar lavage cell counts, protein content, and lung injury scoring. Immunoblotting for MKP-1, and IκBα and cytokine ELISAs were performed on lung lysates. Prone positioning was protective against injurious ventilation in rats. Expression profiling demonstrated MKP-1 20-fold higher in rats ventilated prone rather than supine and regional reduction in p38 and c-jun N-terminal kinase activation. MKP-1(-/-) mice experienced amplified injury. PG490-88 improved static lung compliance and injury scores, reduced bronchioalveolar lavage cell counts and cytokine levels, and induced MKP-1 and IκBα. Injurious ventilation induces MAPK in an MKP-1-dependent fashion. Prone positioning is protective and induces MKP-1. PG490-88 induced MKP-1 and was protective against high Vt in a nuclear factor-κB-dependent manner. MKP-1 is a potential target for modulating regional effects of injurious ventilation.

Clearance of 99mTc-labeled albumin from lungs in anesthetized guinea pigs

International Nuclear Information System (INIS)

Connelly, J.C.; Peterson, B.T.

1993-01-01

Gamma imaging was used to measure the rate of clearance of aerosolized 99m Tc-human serum albumin (HSA) from the lungs of control guinea pigs and guinea pigs that received increased lung inflation or lung injury. Anesthetized guinea pigs were ventilated for 6 min with an aerosol of HSA and the radioactivity in the chest was monitored for 2 h with a gamma camera to determine whether the clearance rate would be a reliable assessment of lung epithelial permeability. Increased lung volumes were effected by application of 5 or 7 cm H 2 O positive end-expired pressure (5-PEEP and 7-PEEP, respectively). Lung injury was induced either by intravenous oleic acid (OA, 27-73 μl/kg) or inhalation of nitrogen dioxide (NO 2 , 80-100 ppm) for 2 h. Postmortem extravascular lung water volume (EVLW) provided an assessment of the degree of lung injury. Tracer clearance rates in animals receiving 5 or 7 cm H 2 O PEEP were not significantly different from controls (K = 0.15 ± 0.05 and 0.24 ± 0.10 vs 0.12 ± 0.03%/min, respectively, p > .05). Animals exposed to NO 2 had faster tracer clearance rates (K = 0.33 ± 0.21%/min, p 2 -exposed guinea pigs correlated well with injury as assessed by EVLW (r = .93, p 2 O PEEP (K = 0.58 ± 0.41%/min, EVLW = 8.1 ± 0.8 mL/g dry lung tissue, p < .05), but there was no correlation between these parameters in this injury model. It is concluded that imaging of the disappearance of radiolabeled HSA in the guinea pig can be a useful index of lung epithelial permeability, but this technique is limited to certain models of lung injury. 33 refs

Tööandja saab võidelda töövägivalla vastu / Meeli Miidla-Vanatalu

Index Scriptorium Estoniae

Miidla-Vanatalu, Meeli

2011-01-01

Töövägivallast ja seda reguleerivatest õigusaktidest. Nõuanded tööandjale Euroopa Tööohutuse ja Töötervishoiu Agentuuri aruandest "Vägivald ja ahistamine töökohal: olukord Euroopas", Aruanne on kättesaadav EU-OSHA kodulehel

Efeitos de diferentes volumes correntes e da pressão expiratória final positiva sobre a troca gasosa na fístula broncopleural experimental Effects of different tidal volumes and positive end expiratory pressure on gas exchange in experimental bronchopleural fistula

Directory of Open Access Journals (Sweden)

Maria Gabriela Cavicchia Toneloto

2008-09-01

Full Text Available OBJETIVO: O presente estudo foi desenhado para identificar o efeito da pressão expiratória final positiva (PEEP e o volume corrente pulmonar ideal para ventilar animais com fístula broncopleural produzida cirurgicamente, com o intuito de reduzir a vazão da fístula sem afetar a troca gasosa. MÉTODOS: Avaliação hemodinâmica e respiratória da troca gasosa foi obtida em cinco porcos jovens, saudáveis, da linhagem Large White, ventilados mecanicamente no modo ventilatório volume controlado com FiO2 de 0.4 e relação inspiração:expiração em torno de 1:2, com freqüência respiratória mantida em 22 cpm. A fístula broncopleural foi produzida pela ressecção da língula. Um sistema de drenagem a selo d'água foi instalado e o tórax foi hermeticamente fechado. A troca gasosa e o débito da fístula broncopleural foram medidos com animais ventilados sequencialmente com volumes correntes de 4 ml/kg, 7 ml/kg e 10 ml/Kg alternando zero de pressão expiratória final positiva (ZEEP e PEEP de 10 cmH2O, sempre na mesma ordem. RESULTADOS: Esses dados são atribuídos à ventilação alveolar reduzida e às anormalidades da ventilação/perfusão que foram atenuadas com volumes correntes mais altos. PEEP aumentou o vazamento de ar pela fístula, mesmo com baixos volumes, de 2.0 ± 2,8mL para 31 ± 20,7mL (p= 0,006 e diminuiu a ventilação alveolar em todos os volumes correntes. A ventilação alveolar melhorou com altos volumes correntes, mas aumentou o débito da fístula (4 ml/kg - 2,0 ± 2,8mL e 10 mL/kg - 80,2 ± 43,9mL; p=0,001. Baixos volumes correntes resultaram em hipercapnia (ZEEP - 83,7± 6,9 mmHg e com PEEP 10 -93 ± 10,1mmHg e diminuição significativa da saturação de oxigênio arterial, em torno de 84%. CONCLUSÃO: O volume corrente de 7 ml/kg com ZEEP foi considerado o melhor volume corrente, visto que, apesar da hipercapnia moderada, a saturação de oxigênio arterial é sustentada em torno de 90%. A ventilação alveolar

Aaviksoo võistleb Donald Trumpiga

Index Scriptorium Estoniae

2007-01-01

Peep Aaviksoole ja tema äripartneritele kuuluv IPC Investment tegeleb Rumeenias lisaks kinnisvarainvesteeringutele ka ehitusmaterjalide tootmisega. USA kinnisvaramagnaat Donald Trump on otsustanud riiki investeerida miljard eurot

Evaluation of right and left ventricular function during adult respiratory distress syndrom using radionuclide angiocardiography conventional and tomographic approaches

International Nuclear Information System (INIS)

Devaux, J.Y.; Dhainaut, J.F.; Roucayrol, J.C.; Brunol, J.

1982-01-01

Despite numerous experimental and clinical studies, the cardiovascular effects of mechanical ventilation with positive-end-expiratory pressure (PEEP) are unclear. Specially, the constant fall in cardiac output is not well undestood. The purpose of this study was to investigate the effects of PEEP on right and left ventricular systolic and diastolic performance before and after volume expansion using angioscintigraphy with red blood cells, in vitro labelled with 99m Tc, a reliable, non invasive method to assess right and left ventricular dimensions and global and segmental contractility. First results in patients with adult respiratory distress syndrom (ARDS) confirm the capabilities of such a method for evaluation of regional wall motion in both ventricles

[Lung protective ventilation. Ventilatory modes and ventilator parameters].

Science.gov (United States)

Schädler, Dirk; Weiler, Norbert

2008-06-01

Mechanical ventilation has a considerable potential for injuring the lung tissue. Therefore, attention has to be paid to the proper choice of ventilatory mode and settings to secure lung-protective ventilation whenever possible. Such ventilator strategy should account for low tidal volume ventilation (6 ml/kg PBW), limited plateau pressure (30 to 35 cm H2O) and positive end-expiratory pressure (PEEP). It is unclear whether pressure controlled or volume controlled ventilation with square flow profile is beneficial. The adjustment of inspiration and expiration time should consider the actual breathing mechanics and anticipate the generation of intrinsic PEEP. Ventilatory modes with the possibility of supporting spontaneous breathing should be used as soon as possible.

Magusaärist lahkuv Kruuda vajas raha investeeringuteks / Lauri Linnamäe

Index Scriptorium Estoniae

Linnamäe, Lauri

2007-01-01

Ärimees Oliver Kruuda müüs Kalevi ja Tere toiduainetööstused Eesti investeerimisfirmale Alta Capital, kelle esindaja Indrek Rahumaa sõnul on mõlemad pooled rahul. Finantsinspektsiooni taunivast suhtumisest müügiettevalmistuste väikeaktsionäride eest saladuses hoidmise pärast. Vt. samas: Võidusõitjast suurinvestor; Savisaar taunis Kalevi müüki; Andrus Karnau intervjuud Oliver Kruudaga: Meediaportaali nimeks saab Kalev.ee. Lisa: Alta Capital Partners; Kalevi grupi struktuur; Skandaalne K-kohuke

Ettevõtja hea nime kaitseks / Olari Koppel

Index Scriptorium Estoniae

Koppel, Olari

2004-01-01

Ilmunud ka: Meie Maa, 1. dets. 2004, lk. 2; Põhjarannik, 30. nov. 2004, lk. 2; Severnoje Poberezhje, 30. nov. 2004, lk. 2; Pärnu Postimees, 2. dets. 2004, lk. 11; Koit, 2. dets. 2004, lk. 6; Sakala, 3. dets. 2004, lk. 2; Hiiu Leht, 3. dets. 2004, lk. 2. Sotsiaaldemokraatide arvates peab ettevõtte ja ettevõtja hea käekäik kajastuma ka töötajate heaolu kasvus. Vastuseks Kalev Kuke art. 24. nov. ajal. Vali Uudised

President tunnustab Pärnumaad kümne riikliku autasuga / Eno-Gerrit Link

Index Scriptorium Estoniae

Link, Eno-Gerrit

2007-01-01

Pärnumaalt saavad iseseisvuspäeva puhul riikliku autasu kümme inimest. Vt. samas: Ester Vilgats. Ivar Kaldasaunal on alati kollektiiviga vedanud; Vello Lahtvee kolmkümmend aastat kohtunikuna. Teenetemärgi pälvinute seas on Lääne-Eesti päästekeskuse direktor Ivar Kaldasaun ja Pärnu maakohtu kohtunik Vello Lahtvee. Vt. ka juhtkiri lk. 15: Vilgats, Kalev. Ebaõigluse visa vastupanu. Rüütliristi kavaler Harald Nugiseks jäi taas teenetemärgist ilma

Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery.

Science.gov (United States)

Hemmes, Sabrine N T; Severgnini, Paolo; Jaber, Samir; Canet, Jaume; Wrigge, Hermann; Hiesmayr, Michael; Tschernko, Edda M; Hollmann, Markus W; Binnekade, Jan M; Hedenstierna, Göran; Putensen, Christian; de Abreu, Marcelo Gama; Pelosi, Paolo; Schultz, Marcus J

2011-05-06

Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP) and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery. The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO") trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH(2)O with recruitment maneuvers (the lung-protective strategy) or mechanical ventilation with the level of PEEP at maximum 2 cmH(2)O without recruitment maneuvers (the conventional strategy). The primary endpoint is any post-operative pulmonary complication. The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications. ISRCTN: ISRCTN70332574.

Ventilation therapy for patients suffering from obstructive lung diseases.

Science.gov (United States)

Jungblut, Sven A; Heidelmann, Lena M; Westerfeld, Andreas; Frickmann, Hagen; Körber, Mareike K; Zautner, Andreas E

2014-01-01

Severe bronchial obstruction due to one of the major pulmonary diseases: asthma, COPD, or emphysema often requires mechanical ventilation support. Otherwise, patients are at risk of severe hypooxygenation with consecutive overloading and dilatation of the right cardiac ventricle with subsequent failure. This review focuses on how to manage a calculated ventilation therapy of patients suffering from bronchial obstruction and relevant patents. Options and pitfalls of invasive and non-invasive ventilation in the intensive care setting regarding clinical improvement and final outcome are discussed. The non-invasive ventilation is very efficient in treating acute or chronic respiratory failure in COPD patients and is capable of shortening the duration of hospitalization. Further non-invasive ventilation can successfully support the weaning after a long-lasting ventilation therapy and improve the prognosis of COPD patients. "Permissive hypercapnia" is unequivocally established in invasive ventilation therapy of severe bronchial obstruction in situations of limited ventilation. When intrinsic positive end-expiratory pressure (PEEP) and elevated airways resistance are present PEEP may be useful although external-PEEP application relieves over-inflation only in selected patients with airway obstruction during controlled mechanical ventilation. Upper limit of airways peak pressure used in "protective ventilation" of adult respiratory distress syndrome (ARDS) patients can be exceeded under certain circumstances.

Low Tidal Volume versus Non-Volume-Limited Strategies for Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.

Science.gov (United States)

Walkey, Allan J; Goligher, Ewan C; Del Sorbo, Lorenzo; Hodgson, Carol L; Adhikari, Neill K J; Wunsch, Hannah; Meade, Maureen O; Uleryk, Elizabeth; Hess, Dean; Talmor, Daniel S; Thompson, B Taylor; Brower, Roy G; Fan, Eddy

2017-10-01

Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results. To compare clinical outcomes of mechanical ventilation strategies that limit tidal volumes and inspiratory pressures (LTV) to strategies with tidal volumes of 10 to 15 ml/kg among patients with ARDS. This is a systematic review and meta-analysis of clinical trials investigating LTV mechanical ventilation strategies. We used random effects models to evaluate the effect of LTV on 28-day mortality, organ failure, ventilator-free days, barotrauma, oxygenation, and ventilation. Our primary analysis excluded trials for which the LTV strategy was combined with the additional strategy of higher positive end-expiratory pressure (PEEP), but these trials were included in a stratified sensitivity analysis. We performed metaregression of tidal volume gradient achieved between intervention and control groups on mortality effect estimates. We used Grading of Recommendations Assessment, Development, and Evaluation methodology to determine the quality of evidence. Seven randomized trials involving 1,481 patients met eligibility criteria for this review. Mortality was not significantly lower for patients receiving an LTV strategy (33.6%) as compared with control strategies (40.4%) (relative risk [RR], 0.87; 95% confidence interval [CI], 0.70-1.08; heterogeneity statistic I 2  = 46%), nor did an LTV strategy significantly decrease barotrauma or ventilator-free days when compared with a lower PEEP strategy. Quality of evidence for clinical outcomes was downgraded for imprecision. Metaregression showed a significant inverse association between larger tidal volume gradient between LTV and control groups and log odds ratios for mortality (β, -0.1587; P = 0.0022). Sensitivity analysis including trials that protocolized an LTV/high PEEP cointervention showed lower mortality associated with LTV (nine trials and 1

[Clinical research of using optimal compliance to determine positive end-expiratory pressure].

Science.gov (United States)

Xu, Lei; Feng, Quan-sheng; Lian, Fu; Shao, Xin-hua; Li, Zhi-bo; Wang, Zhi-yong; Li, Jun

2012-07-01

To observe the availability and security of optimal compliance strategy to titrate the optimal positive end-expiratory pressure (PEEP), compared with quasi-static pressure-volume curve (P-V curve) traced by low-flow method. Fourteen patients received mechanical ventilation with acute respiratory distress syndrome (ARDS) admitted in intensive care unit (ICU) of Tianjin Third Central Hospital from November 2009 to December 2010 were divided into two groups(n = 7). The quasi-static P-V curve method and the optimal compliance titration were used to set the optimal PEEP respectively, repeated 3 times in a row. The optimal PEEP and the consistency of repeated experiments were compared between groups. The hemodynamic parameters, oxygenation index (OI), lung compliance (C), cytokines and pulmonary surfactant-associated protein D (SP-D) concentration in plasma before and 2, 4, and 6 hours after the experiment were observed in each group. (1) There were no significant differences in gender, age and severity of disease between two groups. (2)The optimal PEEP [cm H(2)O, 1 cm H(2)O=0.098 kPa] had no significant difference between quasi-static P-V curve method group and the optimal compliance titration group (11.53 ± 2.07 vs. 10.57 ± 0.87, P>0.05). The consistency of repeated experiments in quasi-static P-V curve method group was poor, the slope of the quasi-static P-V curve in repeated experiments showed downward tendency. The optimal PEEP was increasing in each measure. There was significant difference between the first and the third time (10.00 ± 1.58 vs. 12.80 ± 1.92, P vs. 93.71 ± 5.38, temperature: 38.05 ± 0.73 vs. 36.99 ± 1.02, IL-6: 144.84 ± 23.89 vs. 94.73 ± 5.91, TNF-α: 151.46 ± 46.00 vs. 89.86 ± 13.13, SP-D: 33.65 ± 8.66 vs. 16.63 ± 5.61, MAP: 85.47 ± 9.24 vs. 102.43 ± 8.38, CCI: 3.00 ± 0.48 vs. 3.81 ± 0.81, OI: 62.00 ± 21.45 vs. 103.40 ± 37.27, C: 32.10 ± 2.92 vs. 49.57 ± 7.18, all P safety and usability.

Evaluation of the Efficiency of Alveolar Opening in Cardiosurgical Patients with Low Left Ventricular Ejection Fraction

Directory of Open Access Journals (Sweden)

Yu. G Zorina

2009-01-01

Full Text Available Objective: to determine the optimum alveolar opening parameters for the improvement of postoperative pulmonary oxygenizing function in patients with a left ventricular ejection fraction (LVEF of less or more than 40% after aortocoronary bypass surgery (ACBS. Subjects and methods. Twenty patients with a LVEF of less than 40% after ACBS and with postoperative pulmonary oxygenizing dysfunction (PaO2/FiO2 less than 250 (Group 1 were examined. A control group consisted of 20 patients with a LVEF of more than 40% (Group 2. Gas exchange, respiration biomechanics, and central hemodynamic (CH parameters were monitored (a Vigilance monitor (Edvard LifeScience. Alveolar mobilization was carried out on Drager Evita-2 apparatuses in the BIPAP mode, by taking into account the previous artificial ventilation (AV parameters. The low pressure phase corresponded to the positive end-expiratory pressure (PEEP with volume AV, the high pressure phase was Pplato; the duration of both phases — that of inspiration and expiration (the high pressure phase was inspiration time; the low pressure phase was expiration time. Then the values of Pplato and PEEP were simultaneously increased by 2 cm H2O with a duration of 10 breathing cycles, by continuously monitoring Vt and SaO2 over this interval. By continuously monitoring Vt, a stepwise increase in PEEP and Pplato was continued until there was a Vt reduction or a negative impact of AV on CH. All alveoli were considered to be open when the maximum Vt and SaO2 were achieved. Conclusion. In Group 1 patients with Pinsp of 27—30 cm H2O, PEEP of 10—12 cm H2O, there are increases in PaO2/FiO2 and Cst. In Group 2, the increase of PaO2/FiO2 and Cst is observed with Pinsp of 30—35 cm H2O and PEEP 12—14 cm H2O. With these AV indices, there is an allowable hemodynamic reduction that results in no negative consequences and development of cardiovascular events. After switching to AV in an individually chosen mode, all

Verba volant, scripta manent / Milvi Tedremaa

Index Scriptorium Estoniae

Tedremaa, Milvi, 1937-2012

1999-01-01

Rets. rmt.: Meie õppisime raamatukogundust Tartu Ülikoolis / koost. Maare Kümnik, Kaja Noodla. Tartu, 1998. Vastukaja: Peep, Laine. Mitte ainult Milvi Tedremaale // Raamatukogu (1999) nr. 4, lk. 44

Vastuolud annavad märku muutuste vajadusest / Marit Pukk

Index Scriptorium Estoniae

Pukk, Marit

2002-01-01

Kiiresti areneva firma struktuur vajab muutmist. Kommenteerivad gasellettevõtete juhid Argo Schneider (OÜ Albion Reisid), Peep Nork (AS Euro Truck Trade Center), Riinu Värk (AS Meditsiinigrupp) ja Tiit Elenurm

Takistusriba avalikule teabele / Ivar Tallo

Index Scriptorium Estoniae

Tallo, Ivar, 1964-

2004-01-01

Autori arvates on riiklike registrite poolt jagatava teabe eest tasu võtmine avaliku teabe seadusega vastuolus ega vasta kaasaegsetele infotehnoloogilistele lahendustele. Vastuseks vt.Viljar Peep. Registritest 6.aug. Postimees lk. 10

Põldsamm : 3G lepingu kaotus pole maailma lõpp / Toivo Tänavsuu

Index Scriptorium Estoniae

Tänavsuu, Toivo

2006-01-01

Kolmanda põlvkonna mobiiltelefonivõrgu neljanda sagedusloa väljaandmise avaliku konkursi võitis Venemaa äriühingutele Alkominvest ja Praim kuuluv OÜ Crosson Capital. Bravocomi juhi Peep Põldsammi arvamus

Tallinna Sakala keskuse projekt kütab kirgi / Aivo Vahemets

Index Scriptorium Estoniae

Vahemets, Aivo

2004-01-01

Raine Karbi projekteeritud hoone ümberehituse projekt telliti Inglismaalt büroost Burrow&Cave, OÜ Arhitektuuriagentuuri projektist loobuti. Eesti Arhitektide Liidu esinaise Margit Mutso ja arhitektuurinõukogu esimehe Peep Aaviksoo kommentaar

Titanic või turist? / Karin Paulus

Index Scriptorium Estoniae

Paulus, Karin, 1975-

2006-01-01

Tallinnas Tartu maanteel asuva endise Turisti poe (arhitektid Peep Jänes, Henno Sepmann) asemele tahavad hoone omanikud ehitada kõrghoone nimega Titanic. Hoone ajutine võtmine muinsuskaitse alla on põhjustanud kohtuvaidluse

Prima Vista toob pargiraamatukogu

Index Scriptorium Estoniae

2005-01-01

5. ja 6. mail 2005 toimub teine Tartu kirjandusfestival "Prima Vista". Avatakse pargiraamatukogu, kus esinevad 5. mail Jürgen Rooste, Merca, Aapo Ilves, Peep Ilmet, Marko Martinson, Jüri Kaldmaa, Jaan Pehk

Meeleavaldajad rõhutavad Bonnis kliimaleppe olulisust / Merit Kopli

Index Scriptorium Estoniae

Kopli, Merit, 1969-

2001-01-01

Bonnis peetaval kliimakonverentsil pole seni kasvuhoonegaaside vähendmist sätestava Kyoto lepingu osas edu saavutatud. Eesti Rohelise Liikumise koordinaator Peep Mardiste meeleavaldusest Bonnis. Eesti keskkonnaministeeriumi ametnik Andres Kratonits Bonni kliimakonverentsist

Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery

Directory of Open Access Journals (Sweden)

Hedenstierna Göran

2011-05-01

Full Text Available Abstract Background Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery. Methods The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO" trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH2O with recruitment maneuvers (the lung-protective strategy or mechanical ventilation with the level of PEEP at maximum 2 cmH2O without recruitment maneuvers (the conventional strategy. The primary endpoint is any post-operative pulmonary complication. Discussion The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications. Trial registration ISRCTN: ISRCTN70332574

Norma majandustulemuste ootused käivad üksteisele vastu / Gea Velthut-Sokka

Index Scriptorium Estoniae

Velthut-Sokka, Gea, 1977-

2004-01-01

LHV ja Hansapanga analüütikud ennustavad Normale suurenenud kasumit ja aktsiahinna tõusu, Suprema ennustab nii käibe kui ka kasumi vähenemist. Kommenteerib Norma tegevdirektor Peep Siimon. Diagramm

Ajakirjanikud ajasid metsas hundijälgi / Liisi Seil

Index Scriptorium Estoniae

Seil, Liisi, 1971-

2003-01-01

Hundiuurija Marko Kübarsepp viis teabepäevast "Elu koos hundiga" osalejad Soomaa metsadesse hundijälgi otsima. Kiskja kohta jagasid veel teavet Tõnu Traks, Ilmar Rootsi, Peep Männil ja Jaak Volmer

compliance of the respiratory system as a predictor for successful

African Journals Online (AJOL)

clinical, ventilatory and blood gas criteria were studied. ... pressure (PIP) and positive end-expiratory pressure (PEEP) represented ... criteria for extubation, we found that bedside measurement of total ... position in neutral head-neck posture.

A importância da pressão pleural na avaliação da mecânica respiratória La importancia de la presión pleural en la evaluación de la mecánica respiratoria Importance of pleural pressure for the evaluation of respiratory mechanics

Directory of Open Access Journals (Sweden)

Cláudia Regina Fernandes

2006-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Para a partição das medidas de mecânica do sistema respiratório em seus componentes pulmão e parede torácica, faz-se necessário o conhecimento da pressão pleural. A finalidade desta revisão foi discutir sobre medidas alternativas à obtenção da pressão pleural para o cálculo da mecânica pulmonar, relatar as peculiaridades do método do balão esofágico para obtenção indireta da pressão pleural, as particularidades da obtenção da medida da pressão esofágica em pacientes sedados ou anestesiados, discorrer sobre a medida direta da pressão pleural e sua correlação com a pressão esofágica, assim como relatar sobre o reflexo da PEEP nas pressões pleural e esofágica. CONTEÚDO: A variação da pressão intra-esofágica reflete a variação da pressão intrapleural, podendo ser usada como medida alternativa à pressão pleural direta, no estudo da mecânica dos componentes pulmão e parede do sistema respiratório. A medida da pressão esofágica pode ser realizada por meio de um delicado balão posicionado no interior do esôfago. O método e a técnica foram observados e validados em seres humanos e animais em diferentes condições e posturas corporais. O emprego da PEEP em pacientes sob ventilação controlada mecânica está consolidado; no entanto, existem controvérsias da correlação próxima entre a pressão esofágica e a pressão pleural em pacientes ventilados com PEEP, o que pode resultar em erros de cálculo de mecânica respiratória considerando a pressão esofágica. CONCLUSÕES: O método do balão esofágico é o mais utilizado para a obtenção da medida indireta da pressão pleural. Em pacientes sedados ou anestesiados sem alterações significativas da complacência respiratória, a variação da pressão esofágica corresponde à variação da pressão pleural quando a PEEP é aplicada.JUSTIFICATIVA Y OBJETIVOS: Para la partición de las medidas de mecánica del sistema

Kuidas olla peresõbralik tööandja : muret valmistab erisoodustusmaks, kuid hoolivus on ülesanne number üks

Index Scriptorium Estoniae

2008-01-01

Oma ettevõtte peresõbralikkusest ja paindlikkusest räägivad Kädi Vestberg HR factory OÜ-st, Kadri Johanson CV-Keskusest, Kati Oja reisibüroost Estravel, Helena Erm Scania Eesti AS-ist, Moonika Kähr kinnisvarafirmast Uus Maa, Liina Oks Sampo pangast, Reet Treial Balti Investeeringute Grupi Pank AS-ist, Ülle Matt elektroonikafirmast Elcoteq, Silvia Savik Nukuteatrist, Ülle Filin Tele2 Eesti AS-ist, Sirje Tammiste Sirje Tammiste Konsultandibüroost, Getri Järvsoo Fortum Termest AS-ist ja Kärt Kirso AS-ist Kalev Chocolate Factory

Uudised

Index Scriptorium Estoniae

2007-01-01

Kalev Saare näitus "Portfolio" Võru Linnagaleriis kuni 2. III. Arhitektuurinäitused "Praha kubism" ja Jozhe Plechnik" Eesti Arhitektuurimuuseumis 03.-04. 2007. Tallinnas Soo 4 avatud kunsti- ja sisustusgaleriist SooSoo (galeristid Kadi Kõpper, Ülle Jehe), kus avanäitusena on kuni 17. III väljas Martin Pedaniku graafikaseeria "Kizoo". Hando Tamme maalinäitus "Meie aja kangelased vol 2" Jõhvi Kunstikooli galeriis 5.-31. III. Kunstiteaduste Instituudi Talvefoorum 007 ja muusikaürituste sari Müsteerium 3.-4. III Juurus. Loetletud "Kujundite taaskasutusel" esinejaid

Unistused muudavad maailma / Enn Tammearu

Index Scriptorium Estoniae

Tammearu, Enn

2000-01-01

Rocca al Mare koolimaja ehitamisest, AS KGM Ehitus meeskonnast ja juhatuse esimehest Tiit Nurklikust. Projekti autor: AB Urbel & Peil. Arhitektid Emil Urbel, Indrek Erm, sisearhitekt Taso Mähar, projektijuht Ivar Aus. Konstruktiivne osa: E-Inseneribüroo. Kooli direktori Rein Rebase, I. Ausi, I. Ermi ja T. Nurkliku kommentaarid. Nr. 11, lk. 4-6: Rocca al Mare koolile 2000. a. parima betoonehitise tiitel. Akustik Linda Madalik. Monoliitbetoonitööd: AS Roxor Ehitus. Arvamust avaldavad: T. Nurklik, I. Erm, OÜ Roxoe Ehituse tehniline juht Kalev Ramjalg, žürii esimees Aadu Kana

Lung Transcriptomics during Protective Ventilatory Support in Sepsis-Induced Acute Lung Injury.

Directory of Open Access Journals (Sweden)

Marialbert Acosta-Herrera

Full Text Available Acute lung injury (ALI is a severe inflammatory process of the lung. The only proven life-saving support is mechanical ventilation (MV using low tidal volumes (LVT plus moderate to high levels of positive end-expiratory pressure (PEEP. However, it is currently unknown how they exert the protective effects. To identify the molecular mechanisms modulated by protective MV, this study reports transcriptomic analyses based on microarray and microRNA sequencing in lung tissues from a clinically relevant animal model of sepsis-induced ALI. Sepsis was induced by cecal ligation and puncture (CLP in male Sprague-Dawley rats. At 24 hours post-CLP, septic animals were randomized to three ventilatory strategies: spontaneous breathing, LVT (6 ml/kg plus 10 cmH2O PEEP and high tidal volume (HVT, 20 ml/kg plus 2 cmH2O PEEP. Healthy, non-septic, non-ventilated animals served as controls. After 4 hours of ventilation, lung samples were obtained for histological examination and gene expression analysis using microarray and microRNA sequencing. Validations were assessed using parallel analyses on existing publicly available genome-wide association study findings and transcriptomic human data. The catalogue of deregulated processes differed among experimental groups. The 'response to microorganisms' was the most prominent biological process in septic, non-ventilated and in HVT animals. Unexpectedly, the 'neuron projection morphogenesis' process was one of the most significantly deregulated in LVT. Further support for the key role of the latter process was obtained by microRNA studies, as four species targeting many of its genes (Mir-27a, Mir-103, Mir-17-5p and Mir-130a were found deregulated. Additional analyses revealed 'VEGF signaling' as a central underlying response mechanism to all the septic groups (spontaneously breathing or mechanically ventilated. Based on this data, we conclude that a co-deregulation of 'VEGF signaling' along with 'neuron projection

Lung Transcriptomics during Protective Ventilatory Support in Sepsis-Induced Acute Lung Injury

Science.gov (United States)

Acosta-Herrera, Marialbert; Lorenzo-Diaz, Fabian; Pino-Yanes, Maria; Corrales, Almudena; Valladares, Francisco; Klassert, Tilman E.; Valladares, Basilio; Slevogt, Hortense; Ma, Shwu-Fan

2015-01-01

Acute lung injury (ALI) is a severe inflammatory process of the lung. The only proven life-saving support is mechanical ventilation (MV) using low tidal volumes (LVT) plus moderate to high levels of positive end-expiratory pressure (PEEP). However, it is currently unknown how they exert the protective effects. To identify the molecular mechanisms modulated by protective MV, this study reports transcriptomic analyses based on microarray and microRNA sequencing in lung tissues from a clinically relevant animal model of sepsis-induced ALI. Sepsis was induced by cecal ligation and puncture (CLP) in male Sprague-Dawley rats. At 24 hours post-CLP, septic animals were randomized to three ventilatory strategies: spontaneous breathing, LVT (6 ml/kg) plus 10 cmH2O PEEP and high tidal volume (HVT, 20 ml/kg) plus 2 cmH2O PEEP. Healthy, non-septic, non-ventilated animals served as controls. After 4 hours of ventilation, lung samples were obtained for histological examination and gene expression analysis using microarray and microRNA sequencing. Validations were assessed using parallel analyses on existing publicly available genome-wide association study findings and transcriptomic human data. The catalogue of deregulated processes differed among experimental groups. The ‘response to microorganisms’ was the most prominent biological process in septic, non-ventilated and in HVT animals. Unexpectedly, the ‘neuron projection morphogenesis’ process was one of the most significantly deregulated in LVT. Further support for the key role of the latter process was obtained by microRNA studies, as four species targeting many of its genes (Mir-27a, Mir-103, Mir-17-5p and Mir-130a) were found deregulated. Additional analyses revealed 'VEGF signaling' as a central underlying response mechanism to all the septic groups (spontaneously breathing or mechanically ventilated). Based on this data, we conclude that a co-deregulation of 'VEGF signaling' along with 'neuron projection

Performance of ventilators compatible with magnetic resonance imaging: a bench study.

Science.gov (United States)

Chikata, Yusuke; Okuda, Nao; Izawa, Masayo; Onodera, Mutsuo; Nishimura, Masaji

2015-03-01

Magnetic resonance imaging (MRI) is indispensable for diagnosing brain and spinal cord abnormalities. Magnetic components cannot be used during MRI procedures; therefore, patient support equipment must use MRI-compatible materials. However, little is known of the performance of MRI-compatible ventilators. At commonly used settings, we tested the delivered tidal volume (V(T)), F(IO2), PEEP, and operation of the high-inspiratory-pressure-relief valves of 4 portable MRI-compatible ventilators (Pneupac VR1, ParaPAC 200DMRI, CAREvent MRI, iVent201) and one ICU ventilator (Servo-i). Each ventilator was set in volume control/continuous mandatory ventilation mode. Breathing frequency and V(T) were tested at 10 breaths/min and 300, 500, and 700 mL, respectively. The Pneupac VR1 has fixed V(T) and frequency combinations, so it was tested at V(T) = 300 mL and 20 breaths/min, V(T) = 500 mL and 12 breaths/min, and V(T) = 800 mL and 10 breaths/min. F(IO2) was 0.6 and 1.0. At the air-mix setting, F(IO2) was fixed at 0.5 with the Pneupac VR1, 0.45 with the ParaPAC 200DMRI, and 0.6 with the CAREvent MRI. PEEP was set at 5 and 10 cm H2O, and pressure relief was set at 30 and 40 cm H2O. V(T) error varied widely among ventilators (-28.1 to 25.5%). As V(T) increased, error decreased with the Pneupac VR1, ParaPAC 200DMRI, and CAREvent MRI (P ventilators (-29.2 to 42.5%). Only the Servo-i maintained V(T), F(IO2), and PEEP at set levels. The pressure-relief valves worked in all ventilators. None of the MRI-compatible ventilators maintained V(T), F(IO2), and PEEP at set levels. Vital signs of patients with unstable respiratory mechanics should be monitored during transport and MRI. Copyright © 2015 by Daedalus Enterprises.

"Oravad" tõmbavad Eesti Energia börsileminekule piduri peale / Raimo Poom

Index Scriptorium Estoniae

Poom, Raimo

2010-01-01

Riigikogu Reformierakonna fraktsiooni kohtumisest Eesti Energia juhi Sandor Liive ning majandus- ja kommunikatsiooniministeeriumi esindajatega. Fraktsiooni esimees Peep Aru räägib küsimustest, mis on seotud Eesti Energia börsilemineku kavaga

Kas eesti keelt kummitab sõnavaravaegus? / Virve Liivanõmm

Index Scriptorium Estoniae

Liivanõmm, Virve

2009-01-01

Terminoloogiakonverentsist "Eestikeelne ülikool" Tartus ning Eesti teaduskeele konverentsist Tallinna Ülikoolis. Konverentsidel võtsid sõna Peeter Päll, Mats Estonius, Peeter Saari, Igor Gräzin, Peep Nemvalts, Krista Kerge, Toomas Silk

Samaja bolshaja stroiploshtshadka v Estonii / Konstantin Morenko

Index Scriptorium Estoniae

Morenko, Konstantin

2004-01-01

Tallinna linnavalitsus korraldas ümarlaua linna rannaalade hetkeseisu ja arenguvõimaluste hindamiseks, mille töös osalesid ka Euroopa tuntud linnaplaneerimise konsultandid. Arvamust avaldavad Peep Aaviksoo, Lutz Schleich, Giorgio Risicaris ja Stefan Boltz

Väljaspool iseennast / Aita Kivi

Index Scriptorium Estoniae

Kivi, Aita, 1954-

2000-01-01

Sisu : Jaan Kaplinski. Silm. Hektor; John Grisham. Aguliadvokaat; Kerttu Rakke. Kalevipoeg; luulekogu "Armastuse valgus", koost. Peep Ilmet; James Woodall. John Lennon ja Yoko Ono; Donald Braider. El Greco eraelu; Åke Edwardson. Tants ingliga

Vene kriis kukutas Norma juhid / Raul Ranne

Index Scriptorium Estoniae

Ranne, Raul

1998-01-01

AS Norma vallandas ettevõtte tegevjuhi Peep Aaviksoo, sest ei olnud rahul ettevõtte tegevusega Venemaal. Tabelid: Norma aktsia on kukkunud, Norma kuukasum miinuses. Ilmunud ka: Delovõje Vedomosti, 9. sept. 1998, lk. 10

40 aastat uurivat õpetajat / Raivo Juurak

Index Scriptorium Estoniae

Juurak, Raivo, 1949-

2001-01-01

ÜPUI asutamisest, minevikust ja ka tulevikust. Vestlusringis on Ühiskondliku Pedagoogika Uurimise Instituudi asutajad ja eestvedajad - Helme kutsekooli õpetaja Peep Leppik, TÜ kasvatusteaduste dotsent Inger Kraav, TPÜ emeriitprofessor Inge Unt, TPÜ dotsent Viivi Maanso

Bravocom süüdistab Tele2 ja EMT-d alatus konkurentsivõitluses / Kristiina Viiron

Index Scriptorium Estoniae

Viiron, Kristiina, 1971-

2007-01-01

Kallines Tele2 ja EMT võrgust Bravocomi mobiilinumbritele helistamise minutihind. Bravocomi juhatuse esimees Peep Põldsamm peab nii kalli hinna - 4.50 minut - kehtestamist konkurentsivõitluseks. Tabelid: Hinnavõrdlus. Lisa: Tele2 ja EMT kommentaarid

Eesti animafilmid võitsid Raumas

Index Scriptorium Estoniae

pPIK mare 2010

1999-01-01

VI Sinise Mere filmifestivalil Raumas jagasid A-sarjas esikohta Mait Laasi "Päevavalgus" ja Peep Pedmansoni "Just Märried", teiseks jäi Märt Sildvee "Guardian Angel" ja kolmandaks Riho Undi - Hardi Volmeri "Primavera"

Kunstigaleriist pART on võimalik tellida näitust tutvustavaid loenguid / Ülle Lätte

Index Scriptorium Estoniae

Lätte, Ülle, 1955-

2008-01-01

Kunstigalerii pART näitusel "Nad rõõmustavad meid" eksponeeritakse Põltsamaalt pärit kunstnike Tiit Pääsukese, Peeter Alliku, Toivo Raidmetsa, Viive Väljaotsa, Mare Tralla, Ave Nahkuri, Peep Pedmansoni loomingut

Suurajatolla Ali al-Sistani saabus Najaffi / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2004-01-01

Mässulise shiiidivaimuliku Moqtada al-Sadri Mahdi armee võitlejad on pidanud Najafis USA vägedega lahinguid juba kolm nädalat. Iraagi kõrgeim shiiiavaimulik suurajatolla Ali al-Sistani kutsub kõiki iraaklasi endaga Najaffi marssima, et lahingutele lõpp teha

President Ilves avas Pärnus voodivabriku / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2009-01-01

President Toomas Hendrik Ilves viibis 16. novembril 2009 Pärnus Trading House Scandinavia AB kontserni kuuluva OÜ Stram voodivabriku avamisel. Riigipea tunnustas ettevõtte omanikku Peter Hunti uute töökohtade loomise eest

Kaks teenetemärki Peter Hundile / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2010-01-01

Pärnu maavanem Andres Metsoja andis president Toomas Hendrik Ilvese volitusel AS Wendre suuromanikule Peter Hundile üle Valgetähe IV klassi teenetemärgi ettevõtluse edendamise eest. Ettevõtja pälvis ka Pärnu linna vapimärgi

Al-Zarqawi - terrorist või kangelane? / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2005-01-01

Ilmunud ka: Meie Maa 29. juuni lk. 5. Jordaanias sündinud palestiinlane Abu Musab al-Zarqawi, õige nimega Ahmed Fadel al-Khalaylah, on rühmituse Jama'at al-Tawhid wal Jihad juht ja hetkel kuulsaim sõjapealik Iraagis, kes on pühendanud oma elu võitlusele USA vastu

Mis saab Eesti maaelust 2013. aastal? / Kalev Kotkas

Index Scriptorium Estoniae

Kotkas, Kalev, 1960-

2007-01-01

Ilmunud ka: Nädaline, 14. juuli 2007, lk. 5; Meie Maa, 13. juuli 2007, lk. 2; Järva Teataja, 17. juuli 2007, lk. 2; Valgamaalane, 17. juuli 2007, lk. 2; Hiiu Leht, 17. juuli 2007, lk. 2; Põhjarannik, 13. juuli 2007, lk. 3; Severnoje Poberezhje, 13. juuli 2007, lk. 3; Sõnumitooja, 18. juuli 2007, lk. 2; Pärnu Postimees, 19. juuli 2007, lk. 15; Lääne Elu, 19. juuli 2007, lk. 2; Võrumaa Teataja, 17. juuli 2007, lk. 2; Virumaa Teataja, 20. juuli 2007, lk. 11; Vooremaa, 19. juuli 2007, lk. 2; Sakala, 25. juuli 2007, lk. 2. Autor arutleb maaelu arengukava 2007-2013 meetmete võimaluse üle põllumajanduse konkurentsivõimet parandada ning hoiatab riigikontrolli maaelu käsitleva auditi ja selles prognoositavate majandusraskuste võimalike kaasmõjude eest noorte elukutsevalikule

Ühe ajastu lõpu algus / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2004-01-01

Ilmunud ka: Meie Maa, 9. nov. 2004, lk. 7. Yasser Arafati tervislik seisund on halvenemas, seni pole ta ametlikult kedagi oma järeltulijaks määranud. Palestiinlased peaksid suutma valida talle kombekohase järglase, vastasel juhul satuvad nad keerulisse võimuvõitlusse, millest saab kasu eelkõige Iisrael, leiab autor

Uus etapp Iisraeli võitluses palestiinlastega / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2004-01-01

Ilmunud ka: Meie Maa, 27. apr. 2004, lk. 6. Iisraeli ja Hamasi vahelise võitluse ägenemise käigus tapeti Iisraeli julgeolekujõudude poolt Palestiina äärmusrühmituse Hamas juht Abdel-Aziz al-Rantisi. Lähis-Ida rahuplaani hakkavad Berliinis arutama rahuprotsessi nelja osapoole esindajad - USA, Euroopa Liit, ÜRO ja Venemaa

Peresõbralik firma 2002 - Paikuse Saeveski / Kalev Petti

Index Scriptorium Estoniae

Petti, Kalev

2002-01-01

Ajakiri Pere ja Kodu ja ajaleht Äripäev selgitasid välja Eesti kõige peresõbralikuma ettevõtte. - Lisaks tabelid: Eesti töötajasõbralike ettevõtete TOP 50 ; Peresõbralike firmade TOP 50 ; Töökeskkonnasõbralike firmade TOP 50 ; Töötaja arengu sõbralike firmade TOP 50

Aukonsulid aitavad edendada kontakte Eestiga / interv. Kalev Vilgats

Index Scriptorium Estoniae

2008-01-01

Ülevaade Eesti aukonsulite viiendast konverentsist, millest võttis osa üle 70 aukonsuli rohkem kui 40 riigist. Lisad: Aukonsulid Eestis; Eesti konsulaatide ajalugu. Vt. samas: Kuidas sai teist Eesti aukonsul? Kui palju kulub teie ajast konsulitööle?; Mida arvavad teie tegevusest perekonnaliikmed ja sõbrad? Küsimustele vastavad Eesti aukonsul Moldovas Igor Goncearov, Eesti aukonsul Los Angeleses Jaak Treiman, Eesti aukonsul Tuneesias Abdeljelil Bouraoui, Eesti peaukonsul Sao Paulos Jüri Saukas. Arvamust avaldab ka Eesti välisminister Urmas Paet.

Läänlased, eestlased ja majanduskasv / Kalev Kallemets

Index Scriptorium Estoniae

Kallemets, Kalev, 1979-

2006-01-01

Autori hinnangul suurendaks Reformierakonna liberaalne majanduspoliitika eestlaste investeeringuid Eesti majandusse ja need omakorda eestlaste, sh. läänlaste palgataset. Vt. samas diagrammid: Maksud, investeeringud ja reaalne SKP kasv ELis 1996-2004; Eesti ja Läänemaa palgakasv

Merkel: Nord Streami on meile vaja / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2009-01-01

Venemaa presidendi Dmitri Medvedevi ja Saksamaa kantsleri Angela Merkeli kohtumisel käsitleti energeetikapoliitikat, D. Medvedev kutsus Rootsit üles toetama Nord Streami arendamist ning taunis Nabucco gaasijuhtme rajamist

Midagi enamat kui hea film / Peep Pedmanson

Index Scriptorium Estoniae

Pedmanson, Peep

2006-01-01

Mängufilm "Libahundi needus" : stsenaristid Margus Kasterpalu, Ilmar Raag ja Rainer Sarnet : režissöör Rainer Sarnet : osades Katariina Lauk, Rene Reinumägi : Shop of Dreams - Eesti Televisioon 2005

Poliitikauuringud ja õiguspoliitika kujundamine Eestis / Peep Pruks

Index Scriptorium Estoniae

Pruks, Peep, 1963-

2000-01-01

Poliitikauuringutest lääneriikides (USA-s) ning Ida- ja Kesk-Euroopa üleminekuühiskondades. Mõttekeskustest (think tank), Eesti poliitikauuringute keskusest PRAXIS ning projektidest "Avaliku sektori ja kolmanda sektori õigusloome alane koostöö" ja "Eesti kriminaalmenetluse optimeerimine"

Eesti mood esitles end Stockholmis / Peep Sooman

Index Scriptorium Estoniae

Sooman, Peep, 1978-

1999-01-01

Eesti moepäevadel Stockholmis esitleti moeshow'l üle 80 rõivakollektsiooni, osalesid: Baltika, Klementi, Sangar, Zik-Zak (Ivo Nikkolo), Katrin Kuldma Moemaja, Arne Studio, Hipo, Uljas & Tütred, Virulane, Althea.

Production of Energy Efficient Preform Structures (PEEPS)

Energy Technology Data Exchange (ETDEWEB)

Dr. John A. Baumann

2012-06-08

Due to its low density, good structural characteristics, excellent fabrication properties, and attractive appearance, aluminum metal and its alloys continue to be widely utilized. The transportation industry continues to be the largest consumer of aluminum products, with aerospace as the principal driver for this use. Boeing has long been the largest single company consumer of heat-treated aluminum in the U.S. The extensive use of aluminum to build aircraft and launch vehicles has been sustained, despite the growing reliance on more structurally efficient carbon fiber reinforced composite materials. The trend in the aerospace industry over the past several decades has been to rely extensively on large, complex, thin-walled, monolithic machined structural components, which are fabricated from heavy billets and thick plate using high speed machining. The use of these high buy-to-fly ratio starting product forms, while currently cost effective, is energy inefficient, with a high environmental impact. The widespread implementation of Solid State Joining (SSJ) technologies, to produce lower buy-to-fly ratio starting forms, tailored to each specific application, offers the potential for a more sustainable manufacturing strategy, which would consume less energy, require less material, and reduce material and manufacturing costs. One objective of this project was to project the energy benefits of using SSJ techniques to produce high-performance aluminum structures if implemented in the production of the world fleet of commercial aircraft. A further objective was to produce an energy consumption prediction model, capable of calculating the total energy consumption, solid waste burden, acidification potential, and CO2 burden in producing a starting product form - whether by conventional or SSJ processes - and machining that to a final part configuration. The model needed to be capable of computing and comparing, on an individual part/geometry basis, multiple possible manufacturing pathways, to identify the best balance of energy consumption and environmental impact. This model has been created and populated with energy consumption data for individual SSJ processes and process platforms. Technology feasibility cases studies were executed, to validate the model, and confirm the ability to create lower buy-to-fly ratio performs and machine these to final configuration aircraft components. This model can now be used as a tool to select manufacturing pathways that offer significant energy savings and, when coupled with a cost model, drive implementation of the SSJ processes.

Nukufilm lasi käiku pooletunnise 3D-seiklusfilmi / Tiit Tuumalu

Index Scriptorium Estoniae

Tuumalu, Tiit, 1971-

2009-01-01

Stuudios Nukufilm algasid pooletunnise 3D-nukufilmi "Lisa Limone ja Maroc Orange'i tormakas armulugu" võtted. Filmi režissöör on Mait Laas, stsenaristid Kati Kovacs ja Peep Pedmanson, produtsent Arvo Nuut

Avati mälestuskivi Heinrich Marga sünnikohas / Peep Pillak ; fotod: Peep Pillak ja Valitsuse Kommunikatsioonibüroo

Index Scriptorium Estoniae

Pillak, Peep

2008-01-01

1. oktoobril avati mälestuskivi Eesti Vabariigi valitsuse eksiilis peaministri presidendi ülesannetes Heinrich Marga sünnikohas Põlvamaal Kõlleste (Krootuse) vallas Ihamaru külas Otsa talu juures

Performance of the New Turbine Mid-Level Critical Care Ventilators.

Science.gov (United States)

Delgado, Carlos; Romero, Jose E; Puig, Jaume; Izquierdo, Ana; Ferrando, Carlos; Belda, F Javier; Soro, Marina

2017-01-01

During recent years, ventilators using turbines as flow-generating systems have become increasingly more relevant. This bench study was designed to compare triggering and pressurization of 7 turbine mid-level ICU ventilators. We used a dual-chamber lung model to test 7 mid-level ICU ventilators in pressure support mode with levels of 10, 15, and 20 cm H 2 O with 2 PEEP levels of 5 cm H 2 O and the minimum level allowed by the ventilator. A ventilator was connected to the master chamber to simulate 2 different effort levels. Pressure drop, trigger delay time, time to minimum pressure, and pressure time products (PTP) during trigger and the first 300 and 500 ms were analyzed. In the trigger evaluation, the Savina had the highest delay time, whereas the C2, the V60, and the Trilogy had the lowest pressure drops and PTP values in both effort levels. In pressurization capacity assessment using ideal PTP300 and PTP500 percentages, the C2 and the V680 had the best results, and the Carina and the Savina had lower values, with no differences between both effort levels. Differences between PEEP levels did not seem to be relevant. Pressure support mode for tested ventilators worked properly, but pressurization capacity and trigger function performance were clearly superior in the newest machines. The use of PEEP did not modify the results. Copyright © 2017 by Daedalus Enterprises.

Neopuff T-piece resuscitator mask ventilation: Does mask leak vary with different peak inspiratory pressures in a manikin model?

Science.gov (United States)

Maheshwari, Rajesh; Tracy, Mark; Hinder, Murray; Wright, Audrey

2017-08-01

The aim of this study was to compare mask leak with three different peak inspiratory pressure (PIP) settings during T-piece resuscitator (TPR; Neopuff) mask ventilation on a neonatal manikin model. Participants were neonatal unit staff members. They were instructed to provide mask ventilation with a TPR with three PIP settings (20, 30, 40 cm H 2 O) chosen in a random order. Each episode was for 2 min with 2-min rest period. Flow rate and positive end-expiratory pressure (PEEP) were kept constant. Airway pressure, inspiratory and expiratory tidal volumes, mask leak, respiratory rate and inspiratory time were recorded. Repeated measures analysis of variance was used for statistical analysis. A total of 12 749 inflations delivered by 40 participants were analysed. There were no statistically significant differences (P > 0.05) in the mask leak with the three PIP settings. No statistically significant differences were seen in respiratory rate and inspiratory time with the three PIP settings. There was a significant rise in PEEP as the PIP increased. Failure to achieve the desired PIP was observed especially at the higher settings. In a neonatal manikin model, the mask leak does not vary as a function of the PIP when the flow rate is constant. With a fixed rate and inspiratory time, there seems to be a rise in PEEP with increasing PIP. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Predicting the lung compliance of mechanically ventilated patients via statistical modeling

International Nuclear Information System (INIS)

Ganzert, Steven; Kramer, Stefan; Guttmann, Josef

2012-01-01

To avoid ventilator associated lung injury (VALI) during mechanical ventilation, the ventilator is adjusted with reference to the volume distensibility or ‘compliance’ of the lung. For lung-protective ventilation, the lung should be inflated at its maximum compliance, i.e. when during inspiration a maximal intrapulmonary volume change is achieved by a minimal change of pressure. To accomplish this, one of the main parameters is the adjusted positive end-expiratory pressure (PEEP). As changing the ventilator settings usually produces an effect on patient's lung mechanics with a considerable time delay, the prediction of the compliance change associated with a planned change of PEEP could assist the physician at the bedside. This study introduces a machine learning approach to predict the nonlinear lung compliance for the individual patient by Gaussian processes, a probabilistic modeling technique. Experiments are based on time series data obtained from patients suffering from acute respiratory distress syndrome (ARDS). With a high hit ratio of up to 93%, the learned models could predict whether an increase/decrease of PEEP would lead to an increase/decrease of the compliance. However, the prediction of the complete pressure–volume relation for an individual patient has to be improved. We conclude that the approach is well suitable for the given problem domain but that an individualized feature selection should be applied for a precise prediction of individual pressure–volume curves. (paper)

Assessment of regional ventilation distribution: comparison of vibration response imaging (VRI) with electrical impedance tomography (EIT).

Science.gov (United States)

Shi, Chang; Boehme, Stefan; Bentley, Alexander H; Hartmann, Erik K; Klein, Klaus U; Bodenstein, Marc; Baumgardner, James E; David, Matthias; Ullrich, Roman; Markstaller, Klaus

2014-01-01

Vibration response imaging (VRI) is a bedside technology to monitor ventilation by detecting lung sound vibrations. It is currently unknown whether VRI is able to accurately monitor the local distribution of ventilation within the lungs. We therefore compared VRI to electrical impedance tomography (EIT), an established technique used for the assessment of regional ventilation. Simultaneous EIT and VRI measurements were performed in the healthy and injured lungs (ALI; induced by saline lavage) at different PEEP levels (0, 5, 10, 15 mbar) in nine piglets. Vibration energy amplitude (VEA) by VRI, and amplitudes of relative impedance changes (rel.ΔZ) by EIT, were evaluated in seven regions of interest (ROIs). To assess the distribution of tidal volume (VT) by VRI and EIT, absolute values were normalized to the VT obtained by simultaneous spirometry measurements. Redistribution of ventilation by ALI and PEEP was detected by VRI and EIT. The linear correlation between pooled VT by VEA and rel.ΔZ was R(2) = 0.96. Bland-Altman analysis showed a bias of -1.07±24.71 ml and limits of agreement of -49.05 to +47.36 ml. Within the different ROIs, correlations of VT-distribution by EIT and VRI ranged between R(2) values of 0.29 and 0.96. ALI and PEEP did not alter the agreement of VT between VRI and EIT. Measurements of regional ventilation distribution by VRI are comparable to those obtained by EIT.

Sihtasutus Eesti Rahvuskultuuri Fond...

Index Scriptorium Estoniae

2002-01-01

15. oktoobrini võetakse vastu 2003. a. stipendiumide ja kultuuriprojektide finantseerimise taotlusi. Esimest korda jagatakse stipendiume Peep Keskküla (toetatakse Eesti kunstielu arengut), Renate Jõesaare (stipendium eesti rahvusest isikule, kes on tegev kujutava kunsti alal) jt. fondidest

Urmas Sõõrumaa rentis peoks terve linnahalli / Kirsti Vainküla

Index Scriptorium Estoniae

Vainküla, Kirsti, 1972-

2006-01-01

Peol esilinastub mängufilm "Hundi agoonia", mis valminud tellimustööna : režissöör Asko Kase, produtsent Artur Talvik, stsenarist Peep Pedmanson : RUUT Pictures 2006. Lisaks sõnum "Miljonäri äriimpeerium"

Who named it in anaesthesia?

African Journals Online (AJOL)

Few words existed before 1846 and majority naturally came after. A peep is made .... He had discovered many elements, such as potassium, sodium, barium .... Jokichi Takamine (1854–1922), a Japanese scientist, were trying to isolate and ...

Partial liquid ventilation improves lung function in ventilation-induced lung injury

NARCIS (Netherlands)

G.F. Vazquez de Anda; R.A. Lachmann; S.J.C. Verbrugge (Serge); D.A.M.P.J. Gommers (Diederik); J.J. Haitsma (Jack); B.F. Lachmann (Burkhard)

2001-01-01

textabstractDisturbances in lung function and lung mechanics are present after ventilation with high peak inspiratory pressures (PIP) and low levels of positive end-expiratory pressure (PEEP). Therefore, the authors investigated whether partial liquid ventilation can re-establish

Virmaliste valge kuma / Piret Veigel

Index Scriptorium Estoniae

Veigel, Piret, 1961-

2004-01-01

Kirsi ja Marko Ekströmi valge modernne ridaelamukorter (73 mø) Helsingis. Köögimööbel valmistati Eesti firmas Idema, projekti autor Peep Savason. Idemas tehti ka tualettruumi sisustus. K. Ekströmi kommentaarid. 13 ill

Oistrahhi-festival võtab vastu belgia muusikuid / Toivo Traks

Index Scriptorium Estoniae

Traks, Toivo

2006-01-01

Belgia rahvuspühale pühendatud kontsertidest: fagotimängija Pierre Dubuisson'i esinemisest 21. juulil Pärnu raekoja saalis ja belgia bass-baritoni Lione Lhote ning Peep Lassmanni kontserdist 21. juulil Eliisabeti kirikus, Vanbrugh Quarteti kontserdist Tallinnas

Atonen ja Aaviksoo tegid eile esimese 3G kõne / Viktoria Korpan

Index Scriptorium Estoniae

Korpan, Viktoria, 1976-

2003-01-01

Majandusminister Meelis Atonen ja Eesti Mobiiltelefoni juht Peep Aaviksoo pidasid EMT tehnoloogiakeskuses esimese ametliku kõne 3G testvõrgus. Lisaks tavakõnele videokõnet ja kiiret andmesidet võimaldav teenus jõuab kommertskasutusse orienteeruvalt aastal 2005, lubas Aaviksoo

Lilleküla jalgpallistaadion = Lilleküla Football Stadium / Haldo Oravas

Index Scriptorium Estoniae

Oravas, Haldo, 1960-

2001-01-01

Arhitekt, projekti ja detailplaneeringu (AS Eesti Projekt, 1999) autor Haldo Oravas. Projekteerijad: ETP Grupp, projektijuht Aare Uusalu, arhitekt Peep Urb. Sisekujundaja Sirje Pohl. Projekt 2000-2001. 8 ill.: V korruse ja asendiplaan, tribüüni lõige, vaated

Andres Ellamaa : suurperede seostamine asotsiaalsusega mõjub koletislikult / Andres Ellamaa ; interv. Indrek Veiserik

Index Scriptorium Estoniae

Ellamaa, Andres, 1944-

2008-01-01

Vestlus doktor Andres Ellamaaga suurperede toetamisest, kunstlikust viljastamisest. Lisaks: Kuidas kommenteerite dr. Andres Ellamaa 2. juuni Postimehes ilmunud artikli järel tekkinud diskussiooni avalikkuses ja meedias? Kommenteerivad Tallinna Arstide Liidu juhatuse liige Peeter Mardna ja Jõgeva haigla juhataja Peep Põdder

Lung-protective ventilation in intensive care unit and operation room : Tidal volume size, level of positive end-expiratory pressure and driving pressure

NARCIS (Netherlands)

Serpa Neto, A.

2017-01-01

Several investigations have shown independent associations between three ventilator settings – tidal volume size, positive end–expiratory pressure (PEEP) and driving pressure – and outcomes in patients with the acute respiratory distress syndrome (ARDS). There is an increasing notion that similar

Masin ei küsi kõrgemat palka / Teeli Remmelg

Index Scriptorium Estoniae

Remmelg, Teeli

2007-01-01

Ettevõtjad näevad tööjõupuuduse nappuse lahendusena uute masinate ostmist ja töödistsipliini parandamist. Kommenteerib Ott Licht. Küsimusele vastavad Peep Siimon, Jaanus Vihand, Viktor Valkiainen, Erkki Pärtin, Peeter Mõrd ja Triin Kaasik

Köitekunstist pärikarva / Maarja Undusk

Index Scriptorium Estoniae

Undusk, Maarja

2000-01-01

Rahvusvahelisest köitekunsti ja kalligraafianäirusest "Scripta manent II" Tallinna Kunstihoones. Miks valiti tekstiautoreiks J. Kaplinski ja D. Kareva. Peeter Brambati ja Peep Laansalu videofilmis näidatakse köiteid ka seestpoolt. Filmi muusika - Peeter Vähi

Eramu Suurupis = A House in Suurupi / Tiina Mang

Index Scriptorium Estoniae

Mang, Tiina

2002-01-01

2002. a. valminud eramu projekteeris Arhitektibüroo Emil Urbel. Arhitektid Emil Urbel ja Indrek Erm, sisearhitekt Tiina Mang, konstruktor Peep Rosenberg. Projekt 2000-2001. 7 ill.: I korruse plaan, sise- ja välisvaated.Emil Urbel (arhitektibüroo).

Maardu ja Jõelähtme maa alla võib tulla elektrijaam / Erik Müürsepp

Index Scriptorium Estoniae

Müürsepp, Erik

2009-01-01

OÜ Maardu Graniidikaevandus taotleb graniidikaevanduse luba, ettevõtte juhi Peep Siitami väitel oleks kaeveõõnte hilisem kasutamine pump-hüdroakumulatsioonijaama asukohana parim võimalus kuni 1000 megavati võimsuse ulatuses tuulikuparkide töö ühtlustamiseks

Raudna põhikooli spordihoone Heimtalis = Sports facility at Raudna Basic School in Heimtali / Margit Mutso

Index Scriptorium Estoniae

Mutso, Margit, 1966-

2009-01-01

Heimtali mõisa ringtalli müüride vahele rajatud spordihoonest, žürii hinnang ehitisele, mille arhitekt Peep Jänes pälvis arhitektuuri sihtkapitali aastapreemia 2008. Muinsuskaitse eritingimused koostas Anu Kulbach, sisearhitektid Signe ja Gildardas Stokas, peaprojekteerija K & H

[The influence of positive end-expiratory pressure on cerebral blood flow and cerebrovascular autoregulation in patients with acute respiratory distress syndrome].

Science.gov (United States)

Yang, Chunli; Chen, Zhi; Lu, Yuanhua; He, Huiwei; Zeng, Weihua

2014-05-01

To explore the influence of different positive end-expiratory pressure (PEEP) levels on cerebral blood flow (CBF) and cerebrovascular autoregulation in patients with acute respiratory distress syndrome(ARDS). A prospective study was conducted. Moderate or severe ARDS patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2013 to October 1st, 2013 were enrolled. The changes in hemodynamics, respiratory mechanics and gas exchange under different levels of PEEP were observed. CBF velocity of middle cerebral artery (MCA) was measured using transcranial Doppler (TCD), and breath-holding index (BHI) was also calculated. 35 patients with ARDS were included. The oxygenation index (OI), peak inspiratory pressure (PIP), plat pressure (Pplat) and central venous pressure (CVP) were markedly elevated (OI: 324.7±117.2 mmHg vs. 173.4±95.8 mmHg, t=5.913, P=0.000; PIP: 34.7±9.1 cmH2O vs. 26.1±7.9 cmH2O,t=4.222, P=0.000; Pplat: 30.5±8.4 cmH2O vs. 22.2±7.1 cmH2O, t=4.465, P=0.000; CVP: 12.1±3.5 mmHg vs. 8.8±2.2 mmHg, t=4.723, P=0.000) when PEEP was increased from (6.4±1.0) cmH2O to (14.5±2.0) cmH2O (1 cmH2O=0.098 kPa). But no significant difference in the heart rate (85.5±19.1 beats/min vs. 82.7±17.3 beats/min, t=0.643, P=0.523), mean arterial pressure (73.5±12.4 mmHg vs. 76.4±15.1 mmHg, t=0.878, P=0.383) and CBF velocity of MCA [peak systolic flow velocity (Vmax): 91.26±17.57 cm/s vs. 96.64±18.71 cm/s, t=1.240, P=0.219; diastolic flow velocity (Vmin): 31.54±7.71 cm/s vs. 33.87±8.53 cm/s, t=1.199, P=0.235; mean velocity (Vmean): 51.19±12.05 cm/s vs. 54.27±13.36 cm/s, t=1.013, P=0.315] was found. 18 patients with BHI<0.1 at baseline demonstrated that cerebral vasomotor reactivity was poor. BHI was slightly decreased with increase in PEEP (0.78±0.16 vs. 0.86±0.19, t=1.905, P=0.061). Some of moderate or severe ARDS patients without central nervous system disease have independent of preexisting cerebral

Fluorescent supramolecular micelles for imaging-guided cancer therapy

Science.gov (United States)

Sun, Mengmeng; Yin, Wenyan; Dong, Xinghua; Yang, Wantai; Zhao, Yuliang; Yin, Meizhen

2016-02-01

A novel smart fluorescent drug delivery system composed of a perylene diimide (PDI) core and block copolymer poly(d,l-lactide)-b-poly(ethyl ethylene phosphate) is developed and named as PDI-star-(PLA-b-PEEP)8. The biodegradable PDI-star-(PLA-b-PEEP)8 is a unimolecular micelle and can self-assemble into supramolecular micelles, called as fluorescent supramolecular micelles (FSMs), in aqueous media. An insoluble drug camptothecin (CPT) can be effectively loaded into the FSMs and exhibits pH-responsive release. Moreover, the FSMs with good biocompatibility can also be employed as a remarkable fluorescent probe for cell labelling because the maximum emission of PDI is beneficial for bio-imaging. The flow cytometry and confocal laser scanning microscopy analysis demonstrate that the micelles are easily endocytosed by cancer cells. In vitro and in vivo tumor growth-inhibitory studies reveal a better therapeutic effect of FSMs after CPT encapsulation when compared with the free CPT drug. The multifunctional FSM nanomedicine platform as a nanovehicle has great potential for fluorescence imaging-guided cancer therapy.A novel smart fluorescent drug delivery system composed of a perylene diimide (PDI) core and block copolymer poly(d,l-lactide)-b-poly(ethyl ethylene phosphate) is developed and named as PDI-star-(PLA-b-PEEP)8. The biodegradable PDI-star-(PLA-b-PEEP)8 is a unimolecular micelle and can self-assemble into supramolecular micelles, called as fluorescent supramolecular micelles (FSMs), in aqueous media. An insoluble drug camptothecin (CPT) can be effectively loaded into the FSMs and exhibits pH-responsive release. Moreover, the FSMs with good biocompatibility can also be employed as a remarkable fluorescent probe for cell labelling because the maximum emission of PDI is beneficial for bio-imaging. The flow cytometry and confocal laser scanning microscopy analysis demonstrate that the micelles are easily endocytosed by cancer cells. In vitro and in vivo tumor growth

Respiratory System Mechanics During Low Versus High Positive End-Expiratory Pressure in Open Abdominal Surgery: A Substudy of PROVHILO Randomized Controlled Trial

NARCIS (Netherlands)

D'Antini, Davide; Huhle, Robert; Herrmann, Jacob; Sulemanji, Demet S.; Oto, Jun; Raimondo, Pasquale; Mirabella, Lucia; Hemmes, Sabrine N. T.; Schultz, Marcus J.; Pelosi, Paolo; Kaczka, David W.; Vidal Melo, Marcos Francisco; Gama de Abreu, Marcelo; Cinnella, Gilda

2018-01-01

In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications

Eesti seep saab hoo sisse / Maria Ulfsak

Index Scriptorium Estoniae

Ulfsak, Maria, 1981-

2003-01-01

Kanal 2s algab uus kodumaine komöödiasari "Õpetajate tuba", mille käsikiri on Peep Pedmansonilt, lavastus Ivo Eensalult, näitlejad on Ita Ever, Eino Baskin, Madis Milling, Henrik Normann, Maria Klenskaja, Margus Tabor jt., tootjafirmaks "Ruut"

Associations between positive end-expiratory pressure and outcome of patients without ARDS at onset of ventilation: a systematic review and meta-analysis of randomized controlled trials

NARCIS (Netherlands)

Serpa Neto, Ary; Filho, Roberto Rabello; Cherpanath, Thomas; Determann, Rogier; Dongelmans, Dave A.; Paulus, Frederique; Tuinman, Pieter Roel; Pelosi, Paolo; de Abreu, Marcelo Gama; Schultz, Marcus J.

2016-01-01

The aim of this investigation was to compare ventilation at different levels of positive end-expiratory pressure (PEEP) with regard to clinical important outcomes of intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) at onset of ventilation. Meta-analysis of

Õpetatud Eesti Selts 1988-1991 : [Ülevaade koosolekutest] / Tiit Rosenberg, Maris Pruuli

Index Scriptorium Estoniae

Rosenberg, Tiit, 1946-

1995-01-01

Lisa: Õpetatud Eesti Seltsi taasasutamise ürik : [26 apr. 1988]. Allakirjutanute hulgas Paul Ariste, Eduard Laugaste, Leo Metsar, Aino Põldmäe, Harald Peep, Juhan Peegel, Imbi Pelkonen, Heno Sarv, Arne Merilai, Margus Kasterpalu, Heli Laanekask, Eva Aaver, Paul Hagu, Hando Runnel

Kutseõpetaja - ideaalid ja reaalsus / Ülo Tikk

Index Scriptorium Estoniae

Tikk, Ülo

2003-01-01

Kutseõpetajate koolituse üle vahetavad mõtteid TPÜ töö- ja kutseõpetuse osakonna professor Ants Tarraste, Tallinna Ehituskooli direktor Kaljo-Ilmar Tiitso, Paide Kutsekeskkooli direktori kt. Mare Veermaa, Valga Kutseõppekeskuse õpetaja Peep Leppik ja Tartu abilinnapea Vladimir ?okman

Austraallased huvituvad ETV toodangust / Karin Leemet

Index Scriptorium Estoniae

Leemet, Karin

2000-01-01

ETV saadet "Simson Seakülast" näidatakse peagi Austraalia telekanalil The Special Broadcasting Service. 1995. a. valminud kunstisaade on eesti skulptorist Aivar Simsonist, saate autorid Mariina Mälk, Peeter Brambat, operaator Peep Laansalu. Mari Sobolev A. Simsoni töödest

Application of the Novel Ventilation Mode FLow-Controlled EXpiration (FLEX): A Crossover Proof-of-Principle Study in Lung-Healthy Patients.

Science.gov (United States)

Wirth, Steffen; Springer, Sebastian; Spaeth, Johannes; Borgmann, Silke; Goebel, Ulrich; Schumann, Stefan

2017-10-01

Traditionally, mechanical ventilation is achieved via active lung inflation during inspiration and passive lung emptying during expiration. By contrast, the novel FLEX (FLow-controlled EXpiration) ventilator mode actively decreases the rate of lung emptying. We investigated whether FLEX can be used during intraoperative mechanical ventilation of lung-healthy patients. In 30 adult patients scheduled for neurosurgical procedures, we studied respiratory system mechanics, regional ventilation, oxygenation, and hemodynamics during ventilation with and without FLEX at positive end-expiratory pressure (PEEP) of 5 and 7 cm H2O. The FLEX system was integrated into the expiratory limb and modified the expiratory flow profile by continuously changing expiratory resistance according to a computer-controlled algorithm. Mean airway pressure increased with PEEP by 1.9 cm H2O and with FLEX by 1 cm H2O (all P ventilated during general anesthesia. FLEX improves the homogeneous distribution of ventilation in the lungs.

Common-path Fourier domain optical coherence tomography of irradiated human skin and ventilated isolated rabbit lungs

Science.gov (United States)

Popp, A.; Wendel, M.; Knels, L.; Knuschke, P.; Mehner, M.; Koch, T.; Boller, D.; Koch, P.; Koch, E.

2005-08-01

A compact common path Fourier domain optical coherence tomography (FD-OCT) system based on a broadband superluminescence diode is used for biomedical imaging. The epidermal thickening of human skin after exposure to ultraviolet radiation is measured to proof the feasibility of FD-OCT for future substitution of invasive biopsies in a long term study on natural UV skin protection. The FD-OCT system is also used for imaging lung parenchyma. FD-OCT images of a formalin fixated lung show the same alveolar structure as scanning electron microscopy images. In the ventilated and blood-free perfused isolated rabbit lung FD-OCT is used for real-time cross-sectional image capture of alveolar mechanics throughout tidal ventilation. The alveolar mechanics changing from alternating recruitment-derecruitment at zero positive end-expiratory pressure (PEEP) to persistent recruitment after applying a PEEP of 5 cm H2O is observed in the OCT images.

Reliability of transpulmonary pressure-time curve profile to identify tidal recruitment/hyperinflation in experimental unilateral pleural effusion.

Science.gov (United States)

Formenti, P; Umbrello, M; Graf, J; Adams, A B; Dries, D J; Marini, J J

2017-08-01

The stress index (SI) is a parameter that characterizes the shape of the airway pressure-time profile (P/t). It indicates the slope progression of the curve, reflecting both lung and chest wall properties. The presence of pleural effusion alters the mechanical properties of the respiratory system decreasing transpulmonary pressure (Ptp). We investigated whether the SI computed using Ptp tracing would provide reliable insight into tidal recruitment/overdistention during the tidal cycle in the presence of unilateral effusion. Unilateral pleural effusion was simulated in anesthetized, mechanically ventilated pigs. Respiratory system mechanics and thoracic computed tomography (CT) were studied to assess P/t curve shape and changes in global lung aeration. SI derived from airway pressure (Paw) was compared with that calculated by Ptp under the same conditions. These results were themselves compared with quantitative CT analysis as a gold standard for tidal recruitment/hyperinflation. Despite marked changes in tidal recruitment, mean values of SI computed either from Paw or Ptp were remarkably insensitive to variations of PEEP or condition. After the instillation of effusion, SI indicates a preponderant over-distension effect, not detected by CT. After the increment in PEEP level, the extent of CT-determined tidal recruitment suggest a huge recruitment effect of PEEP as reflected by lung compliance. Both SI in this case were unaffected. We showed that the ability of SI to predict tidal recruitment and overdistension was significantly reduced in a model of altered chest wall-lung relationship, even if the parameter was computed from the Ptp curve profile.

Intratidal Overdistention and Derecruitment in the Injured Lung: A Simulation Study.

Science.gov (United States)

Amini, Reza; Herrmann, Jacob; Kaczka, David W

2017-03-01

Ventilated patients with the acute respiratory distress syndrome (ARDS) are predisposed to cyclic parenchymal overdistention and derecruitment, which may worsen existing injury. We hypothesized that intratidal variations in global mechanics, as assessed at the airway opening, would reflect such distributed processes. We developed a computational lung model for determining local instantaneous pressure distributions and mechanical impedances continuously during a breath. Based on these distributions and previous literature, we simulated the within-breath variability of airway segment dimensions, parenchymal viscoelasticity, and acinar recruitment in an injured canine lung for tidal volumes( V T ) of 10, 15, and 20 mL·kg -1 and positive end-expiratory pressures (PEEP) of 5, 10, and 15 cm H 2 O. Acini were allowed to transition between recruited and derecruited states when exposed to stochastically determined critical opening and closing pressures, respectively. For conditions of low V T and low PEEP, we observed small intratidal variations in global resistance and elastance, with a small number of cyclically recruited acini. However, with higher V T and PEEP, larger variations in resistance and elastance were observed, and the majority of acini remained open throughout the breath. Changes in intratidal resistance, elastance, and impedance followed well-defined parabolic trajectories with tracheal pressure, achieving minima near 12 to 16 cm H 2 O. Intratidal variations in lung mechanics may allow for optimization of ventilator settings in patients with ARDS, by balancing lung recruitment against parenchymal overdistention. Titration of airway pressures based on variations in intratidal mechanics may mitigate processes associated with injurious ventilation.

Lung-protective perioperative mechanical ventilation

NARCIS (Netherlands)

Hemmes, S.N.T.

2015-01-01

Intraoperative ventilation has the potential to cause lung injury and possibly increase risk of pulmonary complications after surgery. Use of large tidal volumes could cause overdistension of lung tissue, which can be aggravated by too high levels of positive end-expiratory pressure (PEEP). Too low

Millise mängufilmi tellis Sõõrumaa Falcki peoks / Andris Feldmanis

Index Scriptorium Estoniae

Feldmanis, Andris, 1982-

2006-01-01

Mängufilm või pseudodokumentaalfilm "Hundi agoonia", mis valminud ärimees Urmas Sõõrumaa tellimustööna turvafirma Falck 15-ks sünnipäevaks : režissöör Asko Kase, produtsent Artur Talvik, stsenarist Peep Pedmanson : RUUT Pictures 2006

Mis on "Sõrmuste isanda" edu saladus?

Index Scriptorium Estoniae

2002-01-01

Toimetuse küsimusele vastavad Ilmar Raag ja Peep Pedmanson. Küsimuse all on Peter Jacksoni esimene film J.R.R. Tolkieni triloogia "Sõrmuste isand" alusel - "Sõrmuse vennaskond", "The Lord of the Rings : The Fellowship of the Ring" : Uus-Meremaa, Ameerika Ühendriigid 2001

Effects of Inhaled Fenoterol and Positive End-Expiratory Pressure on the Respiratory Mechanics of Patients with Chronic Obstructive Pulmonary Disease

Directory of Open Access Journals (Sweden)

Claude Guerin

2005-01-01

Full Text Available BACKGROUND: During acute ventilatory failure in patients with chronic obstructive pulmonary disease (COPD, applying external positive end-expiratory pressure (PEEPe will reopen small airways and, thus, may enhance peripheral deposition as well as the physiological effects of inhaled beta-2 agonists.

Teater kui katk, teater kui haiguste ravi / Kalev Kudu

Index Scriptorium Estoniae

Kudu, Kalev, 1961-

2005-01-01

Antonin Artaud' projekt tegevuskunsti festivalil "Diverse Universe". Projekti lavastas Tartu Üliõpilasteatri näitlejate ja Tartu Ülikooli kahe teatritudengiga Ph. Brehse Berliini performance'irühmast Open Space. Workshop Tartu Üliõpilasmajas 3.-6. maini ja 6. mail Sadamateatris etendus "Katk". Lisatud lavastaja ja osalejate arvamused õpikojast

Värvid meie ümber / Kalev Vene, Herki Tomberg

Index Scriptorium Estoniae

Vene, Kalev

2001-01-01

Värvid läbi aastatuhandete, esiisadeaegne värvitööstus, värvide põhikomponendid, erinevate värvitüüpide funktsioonid, värvide jaotus ja omadused, punamuldvärv, õlivärv, liimvärv. Järg: nr. 9, lk. 44-45, nr. 10, lk. 18-21, nr. 11, lk.40-41, nr. 12, lk. 31-31. Vaid I osa kokkuvõte inglise ja vene keeles

Põhja-Korea tuumakriisis saavutati läbimurre / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2007-01-01

Kuuepoolsel läbirääkimisel sõlmitud leppe järgi lubab Põhja-Korea sulgeda vaidlusaluse Youngbyoni tuumajaama, kus valmistatakse väidetavalt plutooniumi, peatingimuseks saada vastutasuks suures koguses elektrienergiat

Mõjuka majandusteoreetiku väärikas lahkumine / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2006-01-01

Suri üks mõjukamaid kaasaja majandusteoreetikuid Milton Friedman, keda seostatakse eelkõige monetaristliku majandusteooriaga, mis rõhutab vabaturumajanduse arendamist ja valitsuse võimalikult vähest sekkumist majandustegevusse

Dokumentaalfilm "Laulev revolutsioon" tähistab vabadust / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2007-01-01

Dokumentalistide James Tusty ja Maureen Castle Tusty Eesti taasiseseisvumisest kõnelevast dokumentaalfilmist kui suurepärasest Eesti tutvustajast maailmale kirjutab oma koduleheküljel USA uuringute firma Media Research Center president L. Brent Bozell III. Refereering

Bussipark müüdud, mured murtud? / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2004-01-01

Pärnu linnavalitsus müüs 51,39% bussifirma Pärnu ATP AS-i aktsiaist 11 miljoni kroonise alghinnaga ainsana pakkumise teinud Trandemark OÜ-le. Autor tõstatab küsimuse ostjafirma omanikest ja reisijateveo jätkamise tingimustest

Eraõigusliku juriidilise isiku organi liikmete õigussuhted / Kalev Saare

Index Scriptorium Estoniae

Saare, Kalev, 1974-

2010-01-01

Eraõiguslike juriidiliste isikute organi mõistest aktsiaseltsi ja osaühingu näitel, organiliikmete sisesuhte tekkimisest ja tsiviilseadustiku üldosa seaduse poolt määratud sisesuhte sisusse kuuluvatest peamistest kohustustest

Mida teha järjepideva rahvastikuarengu nimel / Kalev Katus

Index Scriptorium Estoniae

Katus, Kalev, 1955-2008

2007-01-01

Rahvastikuteadlane annab ülevaate Eesti rahvastiku sündimustasemest kui rahvastikuprotsesse enim mõjutanud tegurist, analüüsib erinevate meetmete, sh rahakesksete meetmete mõju sündimusele ja pakub välja abinõud, mis aitavad tõsta sündimuse taastetasemele. Lisatud diagramm ja graafikud

32 CFR Appendix D to Part 154 - Reporting of Nonderogatory Cases

Science.gov (United States)

2010-07-01

... travel, education, visits, correspondence, relatives, or contact with persons from or living in a foreign..., window-peeping, and similar situations from whatever source. Unlisted full-time employment or education; full-time education or employment that cannot be verified by any reference or record source or that...

Early Phonological Development: Creating an Assessment Test

Science.gov (United States)

Stoel-Gammon, Carol; Williams, A. Lynn

2013-01-01

This paper describes a new protocol for assessing the phonological systems of two-year-olds with typical development and older children with delays in vocabulary acquisition. The test (Profiles of Early Expressive Phonological Skills ("PEEPS"), Williams & Stoel-Gammon, in preparation) differs from currently available assessments in…

Eestil odava tööjõu eelis kadunud / Liis Kängsepp

Index Scriptorium Estoniae

Kängsepp, Liis, 1981-

2005-01-01

Database Central Europe'i tehtud tööjõu maksumuse uuringu järgi on tööjõukulu Eestis tunduvalt suurem kui Lätis, Leedus ning mitmes Ida-Euroopa riigis. Diagrammid. Kommenteerivad: Peep Siimon, Taavi Veskimägi, Jaak Leimann ja Ilmar Petersen

The value of laparoscopic classifications in decision on definitive ...

African Journals Online (AJOL)

The value of laparoscopic classifications in decision on definitive surgery in patients ... was to present our clinical experience with the laparoscopic approach in patients ... in 10 cases in whom cord structures were seen entering the internal inguinal ring. ... Four canalicular testes (peeping) were treated with open orchiopexy.

Eesti funktsionalismi näitus Jyväskyläs / Karin Hallas-Murula

Index Scriptorium Estoniae

Hallas-Murula, Karin, 1957-

2002-01-01

6. VIII-15. IX Alvar Aalto muuseumis Eesti Arhitekuurimuuseumi näitus "Funktsionalism Eestis". Eksponeeritakse 1930. aastate originaalprojekte, digitaliseeritud ajaloolisi fotosid ning makette. Näituse ja kataloogi on koostanud Karin Hallas-Murula, näituse kujundanud Peeter Mauer, kataloogi kujundanud Jaanus Tamme ja Jaak Peep (Tank)

Õpetaja, kus asub Kennedy neem? / Marii Karell

Index Scriptorium Estoniae

Karell, Marii, 1980-

2003-01-01

Kanal 2s algab uus kodumaine komöödiaseriaal "Õpetajate tuba", mille käsikiri on Peep Pedmansonilt, lavastaja Ivo Eensalu, kes artiklis meenutab oma kooliaegu. Lisaks sõnumid "Eino Baskin sokutas õpetaja istumise alla siili" ja "Madis Milling - rohkem kõnemees kui tangensite tagaajaja"

Kuus uut Eesti filmi korraga ekraanil / Tarmo Teder

Index Scriptorium Estoniae

Teder, Tarmo

1998-01-01

21. mail esilinastuvad kinos Sõprus 'Just märried', rezh. Peep Pedmanson; 'Päevavalgus', rezh. Mait Laas; 'Primavera', rezh. Riho Unt ja Hardi Volmer; 'Vares ja hiired', rezh. Priit Tender ja Mikk Rand; 'Bermuda', rezh. Ülo Pikkov; 'Tom ja Fluffy', rezh. Janno Põldma ja Heiki Ernits

Lung-Protective Ventilation Strategies for Relief from Ventilator-Associated Lung Injury in Patients Undergoing Craniotomy: A Bicenter Randomized, Parallel, and Controlled Trial

Directory of Open Access Journals (Sweden)

Chaoliang Tang

2017-01-01

Full Text Available Current evidence indicates that conventional mechanical ventilation often leads to lung inflammatory response and oxidative stress, while lung-protective ventilation (LPV minimizes the risk of ventilator-associated lung injury (VALI. This study evaluated the effects of LPV on relief of pulmonary injury, inflammatory response, and oxidative stress among patients undergoing craniotomy. Sixty patients undergoing craniotomy received either conventional mechanical (12 mL/kg tidal volume [VT] and 0 cm H2O positive end-expiratory pressure [PEEP]; CV group or protective lung (6 mL/kg VT and 10 cm H2O PEEP; PV group ventilation. Hemodynamic variables, lung function indexes, and inflammatory and oxidative stress markers were assessed. The PV group exhibited greater dynamic lung compliance and lower respiratory index than the CV group during surgery (P0.05. Patients receiving LPV during craniotomy exhibited low perioperative inflammatory response, oxidative stress, and VALI.

Comparison between conventional and protective one-lung ventilation for ventilator-assisted thoracic surgery.

Science.gov (United States)

Ahn, H J; Kim, J A; Yang, M; Shim, W S; Park, K J; Lee, J J

2012-09-01

Recent papers suggest protective ventilation (PV) as a primary ventilation strategy during one-lung ventilation (OLV) to reduce postoperative pulmonary morbidity. However, data regarding the advantage of the PV strategy in patients with normal preoperative pulmonary function are inconsistent, especially in the case of minimally invasive thoracic surgery. Therefore we compared conventional OLV (VT 10 ml/kg, FiO2 1.0, zero PEEP) to protective OLV (VT 6 ml/kg, FiO2 0.5, PEEP 5 cmH2O) in patients with normal preoperative pulmonary function tests undergoing video-assisted thoracic surgery. Oxygenation, respiratory mechanics, plasma interleukin-6 and malondialdehyde levels were measured at baseline, 15 and 60 minutes after OLV and 15 minutes after restoration of two-lung ventilation. PaO2 and PaO2/FiO2 were higher in conventional OLV than in protective OLV (PProtective ventilation did not provide advantages over conventional ventilation for video-assisted thoracic surgery in this group of patients with normal lung function.

Anesthetic management of the SRS™ Endoscopic Stapling System for gastro-esophageal reflux disease.

Science.gov (United States)

Topuz, Ufuk; Umutoglu, Tarik; Bakan, Mefkur; Ozturk, Erdogan

2013-01-14

The SRS(TM) Endoscopic Stapling System (Medigus, Tel Aviv, Israel) is a new tool capable of creating a totally endoscopic fundoplication, combined with an endoscope, endoscopic ultrasound and a surgical stapler. SRS(TM) endoscopic stapling for gastro-esophageal reflux disease is a minimally invasive, outpatient procedure, which requires general anesthesia with positive-pressure ventilation. Keeping the patient on positive end-expiratory pressure (PEEP) may minimize the pressure gradient between the esophagus and the mediastinum, as well as help to prevent air from leaking around the screws and causing pneumomediastinum. In addition, in patients with hiatal hernia, higher PEEP levels may be required to increase intra-thoracic pressure and to force the stomach to slide into the abdomen for ease of endoscopy. We advise smoother emergence from anesthesia, taking precautions for retching, postoperative nausea and vomiting (PONV), while coughing and gagging during extubation and PONV may affect the success of the procedure. Total intravenous anesthesia with propofol and remifentanil seems to be a good choice for these reasons.

Eesti arhiivid Euroopa kontekstis / Lea Kõiv, Peep Pillak

Index Scriptorium Estoniae

Kõiv, Lea, 1961-

2013-01-01

2005. aastal toimus konverents "Eesti arhiivid Euroopa kontekstis". Selle konverentsil esitatud ettekannete baasil ilmunud kogumikust "Die Archive Estlands im Europäischen Kontxt/Estonian Archives in the European Context". Kogumikus sisalduvatest artiklitest

Kolm jääaegset triumfi / Peep Pedmanson

Index Scriptorium Estoniae

Pedmanson, Peep

2002-01-01

Tallinnas ja Tartus tuli ekraanile USA joonisfilm "Jääaeg" ("Ice Age"), mille dubleerimisse on režissöör Janno Põldma juhtimisel kaasatud parimad eesti näitlejad. Eriti Anu Lambi meisterlikkusest laisklooma dubleerimisel ning arvutianimatsiooni kõrgest tasemest

Schaulust und Horror Soziokulturelle - Perspektiven auf PEEPING TOM

Directory of Open Access Journals (Sweden)

Thomas Ballhausen

2010-09-01

Full Text Available Die Geschichte des Kinos und des Films ist mindestens ebenso sehr eine Geschichte des Schreckens (und der damit verbundenen Schaulust wie sie eine Geschichte des Dokumentarischen zu sein scheint. Es sind die außergewöhnlichen Körper und deren Bewegungen, die das Publikum zu allen Zeiten faszinierten, schockierten und zum Schauen und Sehen lockten. Besonders das Genre des Horrorfilms ist mit diesem zentralen Aspekt des Kinos besonders deutlich verbunden.

Anneli Remme soovitab : "Peeter!". Ciacinto Scelsi - mees Ida ja Lääne piirilt / Anneli Remme

Index Scriptorium Estoniae

Remme, Anneli, 1968-

2002-01-01

21. mail ja 1. juunil etendub Kanuti Gildi saalis tragikoomiline ning ühiskonnakriitiline dokumentaalooper "Peeter!", kus Areeni toimetajad Barbi Pilvre ja Tõnu Kaalep toovad avalikkuse ette tõlgenduse toimetaja Kalev Kesküla ja kirjanduskriitik Peeter Künstleri sõpruse tähelepanuväärsetest omadustest. Vastavaid osi esitavad laval Jaan-Villem Sibul ja Indrek Taalmaa. Eesti värskeima multimeediumi juurde kuulub tants ning Andres Maimiku - Jaak Kilmi filmikaadrid mitmete "avalike loomeinimeste" osalusel. Helilooja Toomas Trass. 30. mail toimub Eesti Muusikaakadeemia orelisaalis loeng-kontsert Scelsi muusikast, esinevad Tarmo Johannes (flöödid ja loeng) ning Vambola Krigul (löökpillid)

Parts pakub pensionilisa kinnisvara tagatisel / Kadri Bank

Index Scriptorium Estoniae

Bank, Kadri

2008-01-01

Ilmunud ka: Delovõje Vedomosti 30. jaan. lk. 4. Majandusminister Juhan Parts pakub välja ideed, mis võimaldaks pensionäril saada oma kinnisvara eest igakuist pensionilisa. Vt. samas: Skeem: Pensionilisa kinnisvara tagatisel; Vanurid koduga riskima ei tõtta. Kommenteerivad Valdek Mikkal, Triin Messimas ja Peep Sooman

"Siis sõi Sõõrumaa Punamütsikese ka ära..." / Jüri Muttika

Index Scriptorium Estoniae

Muttika, Jüri

2006-01-01

Mängufilm või pseudodokumentaalfilm "Hundi agoonia", mis valminud ärimees Urmas Sõõrumaa tellimustööna turvafirma Falck 15-ks sünnipäevaks : režissöör Asko Kase, produtsent Artur Talvik, stsenarist Peep Pedmanson : RUUT Pictures 2006. Lisaks tutvustus "Hundi agoonia"

Norma juht hämas Venemaa osas / Annika Matson

Index Scriptorium Estoniae

Matson, Annika, 1976-

2005-01-01

Norma juhatuse esimees Peep Siimon teatas osalise tööaja rakendamise vajadust 551 töötaja puhul ning põhjendab seda keerulise olukorraga Venemaal. Diagramm: Vene autoturg kasvab. Vt. samas: Eesti analüütikud osalise tööaja teadet ei pelga. Kommenteerib Valentin Jurkin

The effect of positive end-expiratory pressure on pulse pressure ...

African Journals Online (AJOL)

The effect of positive end-expiratory pressure on pulse pressure variation. FJ Smith, M Geyser, I Schreuder, PJ Becker. Abstract. Objectives: To determine the effect of different levels of positive end-expiratory pressure (PEEP) on pulse pressure variation (PPV). Design: An observational study. Setting: Operating theatres of a ...

Persistent puhnonary hypertension ofthe neonate in a developing ...

African Journals Online (AJOL)

the study period. Their clinical characteristics are dis- played in Tables IT and ITl. Comparison of the clinical, ventilatory and laboratory findings of the survivors v. the non-survivors .... Fio, = fractional concentration of inspired oxygen; PEEP = positive end expiratory ... had multi-organ failure and was assessed as having a.

[A comparative study between inflation and deflation pressure-volume curve in determining the optimal positive end-expiratory pressure].

Science.gov (United States)

Gang, Li; Sun, Xiao-yi; Xu, Jin-quan; Zhang, Xin-li; Kou, Lu-xin; Jiang, Zhi-hong; Zhang, Lei

2012-02-01

To determine the optimal positive end-expiratory pressure (PEEP) according to inflation and deflation pressure-volume curve (P-V curve) in patients with acute respiratory distress syndrome (ARDS). ARDS models were reproduced in 20 dogs, and they were randomly divided into two groups. In both groups, Levenberg-Marquardt iterative algorithm was employed using software to explore parameters fitting with Boltzmann formula, by which the real inflection point of pressure (Pinf d) in deflation limb or lower inflection point pressure (PLip) in inflation limb on P-V curve were defined. For the control group (inflation curve) P-V curve of PLip + 2 cm H(2)O [1 cm H(2)O = 0.098 kPa] was applied as the best PEEP value. In the experimental group (deflation curve) the Pinf d was taken as the best PEEP value. The heart rate (HR), blood pressure (BP), fingertip pulse oxygen saturation [SpO(2)], static lung compliance (Cst), arterial partial pressure of oxygen [PaO(2)] and arterial partial pressure of carbon dioxide [PaCO(2)] were monitored at 0, 2, 6, 12, 24 and 48 hours. Oxygenation index increased significantly both in control and experimental groups. In experimental group, oxygenation index (mm Hg, 1 mm Hg = 0.133 kPa) of 12, 24 and 48 hours was respectively significantly higher than that of the control group (12 hours: 177.63 ± 8.94 vs. 165.60 ± 8.90, 24 hours: 194.19 ± 10.67 vs. 168.70 ± 10.60, 48 hours: 203.15 ± 13.21 vs. 171.26 ± 9.21, all P deflation P-V curve was better than that of inflation curve.

Feasibility of Protective Ventilation During Elective Supratentorial Neurosurgery: A Randomized, Crossover, Clinical Trial.

Science.gov (United States)

Ruggieri, Francesco; Beretta, Luigi; Corno, Laura; Testa, Valentina; Martino, Enrico A; Gemma, Marco

2017-06-30

Traditional ventilation approaches, providing high tidal volumes (Vt), produce excessive alveolar distention and lung injury. Protective ventilation, employing lower Vt and positive end-expiratory pressure (PEEP), is an attractive alternative also for neuroanesthesia, when prolonged mechanical ventilation is needed. Nevertheless, protective ventilation during intracranial surgery may exert dangerous effects on intracranial pressure (ICP). We tested the feasibility of a protective ventilation strategy in neurosurgery. Our monocentric, double-blind, 1:1 randomized, 2×2 crossover study aimed at studying the effect size and variability of ICP in patients undergoing elective supratentorial brain tumor removal and alternatively ventilated with Vt 9 mL/kg-PEEP 0 mm Hg and Vt 7 mL/kg-PEEP 5 mm Hg. Respiratory rate was adjusted to maintain comparable end-tidal carbon dioxide between ventilation modes. ICP was measured through a subdural catheter inserted before dural opening. Forty patients were enrolled; 8 (15%) were excluded after enrollment. ICP did not differ between traditional and protective ventilation (11.28±5.37, 11 [7 to 14.5] vs. 11.90±5.86, 11 [8 to 15] mm Hg; P=0.541). End-tidal carbon dioxide (28.91±2.28, 29 [28 to 30] vs. 28.00±2.17, 28 [27 to 29] mm Hg; Pprotective ventilation. Blood pressure, heart rate, and body temperature did not differ between ventilation modes. Dural tension was "acceptable for surgery" in all cases. ICP differences between ventilation modes were not affected by ICP values under traditional ventilation (coefficient=0.067; 95% confidence interval, -0.278 to 0.144; P=0.523). Protective ventilation is a feasible alternative to traditional ventilation during elective neurosurgery.

Human or monitor feedback to improve mask ventilation during simulated neonatal cardiopulmonary resuscitation.

Science.gov (United States)

Binder, Corinna; Schmölzer, Georg M; O'Reilly, Megan; Schwaberger, Bernhard; Urlesberger, Berndt; Pichler, Gerhard

2014-03-01

To investigate if external chest compressions (ECC) increase mask leak, and if human or technical feedback improves mask ventilation during simulated neonatal cardiopulmonary resuscitation (CPR). In this observational study, 32 participants delivered positive pressure ventilation (PPV) to a modified, leak-free manikin via facemask. Mask leak, tidal volume (VT), positive end expiratory pressure (PEEP) and respiratory rate (RR) were measured with a respiratory function monitor (RFM). Participants had to perform four studies. In the first study, participants performed PPV alone as baseline. Thereafter, three studies were performed in random order. In the PPV+ECC+manometer group, participants had to observe the manometer while the RFM was covered; in the PPV+ECC+RFM group, the RFM was used while the manometer was covered; and in the PPV+ECC+verbal feedback group, the RFM and manometer were covered while a team leader viewed the RFM and provided verbal feedback to the participants. Median (IQR) mask leak of all studies was 15% (5-47%). Comparing the studies, PPV+ECC+RFM and PPV+ECC+verbal feedback had significantly less mask leak than PPV+ECC+manometer. Mean (SD) VT of all studies was 9.5±3.5 mL. Comparing all studies, PPV+ECC+RFM had a significantly higher VT than PPV and PPV+ECC+manometer. As well, PPV+ECC+verbal feedback had a significantly higher VT than PPV. PEEP and RR were within our target, mean (SD) PEEP was 6±2 cmH2O and RR was 36±13/min. During simulated neonatal CPR, ECCs did not influence mask leak, and a RFM and verbal feedback were helpful methods to reduce mask leak and increase VT significantly.

Teater täis sära ja müstikat / Ell-Maaja Randküla

Index Scriptorium Estoniae

Randküla, Ell-Maaja, 1939-2016

2005-01-01

Tallinnas Pärnu mnt. 5 asuva Eesti Draamateatri renoveerimine. Sisekujundus: Mari Kurismaa, Stuudio Kurismaa. Arhitektuurne lahendus: AB Kolde Grupp ( arhitektid Peep Jänes, Indrek Suigusaar). Ehitus: AS Estconde E. Mari Kurismaast, tema tähtsamad loomingulised saavutused maalikunstnikuna ja sisearhitektina. M. Kurismaa kommentaarid. Ill.: plaan, 10 värv. vaadet

Telesügis: uued omasaated ja õnnemängud / Erika Klaats

Index Scriptorium Estoniae

Klaats, Erika, 1954-

2010-01-01

ETV ekraanile jõudvatest draamasarjadest "Klass: elu pärast" ja "ENSV" ning Mati Talviku ajaloosarjast "Ajavaod". Kanal 2 ekraanile jõudvast draamasarjast "Pilvede all", dokumentaalsarjast "Eesti maffia", saatest "Tantsud tähtedega". TV 3 ekraanile jõudvast saatest "Eesti talent" ja komöödiasarjast "Kälimehed" (stsenarist Peep Pedmanson)

Läänemere filmiamatöörid Tallinnas

Index Scriptorium Estoniae

2002-01-01

5. ja 6. oktoobril peeti Tallinna Kinomajas 33. avatud Balti amatöörfilmide festival, mille žüriid juhtis Peep Puks. Ühe II auhinna sai Daniel Müntineni alias Dan Leadi animafilm "Punapäine päikeseloojang" ja ühe III auhinna Elen Lotmani tõsielufilm "Homo sapiens"

An experimental randomized study of six different ventilatory modes in a piglet model with normal lungs

DEFF Research Database (Denmark)

Nielsen, J B; Sjöstrand, U H; Henneberg, S W

1991-01-01

-controlled intermittent positive-pressure ventilation; and SV-20P denotes pressure-controlled intermittent positive-pressure ventilation. With all modes of ventilation a PEEP of 7.5 cm H2O was used. In the abbreviations used, the number denotes the ventilatory frequency in breaths per minute (bpm). HFV indicates that all...

Surfactant impairment after mechanical ventilation with large alveolar surface area changes and effects of positive end-expiratory pressure

NARCIS (Netherlands)

S.J.C. Verbrugge (Serge); S.H. Bohm; D.A.M.P.J. Gommers (Diederik); L.J.I. Zimmermann (Luc); B.F. Lachmann (Burkhard)

1998-01-01

textabstractWe have assessed the effects of overinflation on surfactant function and composition in rats undergoing ventilation for 20 min with 100% oxygen at a peak inspiratory pressure of 45 cm H2O, with or without PEEP 10 cm H2O (groups 45/10 and 45/0, respectively).

Tallinna ülikool ehitab uue Ursa maja / Mihkel Tamm

Index Scriptorium Estoniae

Tamm, Mihkel

2017-01-01

2018. a. veebruaris kavatseb Tallinna Ülikool hakata lammutama loodus- ja terviseteaduste õppehoonet ehk Ursa maja. Amortiseerunud hoone asemele ehitatakse uus, mille uksed loodetakse tudengitele avada 2019. aasta sügissemestriks. Selgitusi uue hoone kahta jagab TLÜ kantsler Peep Jonas ning kavandatava õueala kohta keskkonnakorralduse professor Helen Sooväli-Sepping

Kriisiaasta - tasu tõusis 300 000krooni : Ülikoolid: rektorite sissetulek kasvab / Kadri Paas

Index Scriptorium Estoniae

Paas, Kadri, 1982-

2010-01-01

Eesti suuremate kõrgkoolide rektorite sissetulek on aastaid kerkinud, sõltumata sellest, kas majandus õitseb või langeb. Mullust edetabelit juhib Tallinna Tehnikaülikooli rektor Peep Sürje, kelle aastatasu kerkis 300 000 krooni võrra. Ka Tartu Ülikooli rektori Alar Karise ja Tallinna Ülikooli rektori Rein Raua palkadest

Director läks ja küsis / Indrek Randveer, Evelyn Karming, Priit Palk ... [jt.

Index Scriptorium Estoniae

2010-01-01

EMT teenindus- ja müügidirektor Indrek Randveer, Estraveli müügidirektor Evelyn Karming, ABC King/Nero/SHU/Suurtüki turundusjuht Anne-Liis Ostov, kohvik-restoran Crepp juhataja Priit Palk ja Sokos Hotel Viru kommunikatsioonijuht Peep Ehasalu vastavad küsimustele, mis puudutavad nende kogemusi keerukate ja absurdsete kliendikaebuste kohta

Teated

Index Scriptorium Estoniae

2008-01-01

Kontserdid TÜ aulas: Tartu Ülikooli kammerkoori kevadkontsert 16. märtsil, pianist Peep Lassmann 18. märtsil (kavas: Sumera "Pala aastast 1981", Liszt-Rossini "Stabat Mater", Liszt-Verdi "Rigoletto parafraas", Liszt "Tuisk" ja "Hispaania rapsoodia"), saksofonikvartett Sax-Est 19. märtsil, kontsert "Richard Ritsing - 105" 28. märtsil

3 Level Ventilation: the First Clinical Experience

Directory of Open Access Journals (Sweden)

P. Torok

2008-01-01

Full Text Available Considering the issues of artificial ventilation (AV in non-homogenous pathological lung processes (acute lung injury (ALI, acute respiratory distress syndrome (ARDS, pneumonia, etc., the authors applied the three-level lung ventilation to a group of 12 patients with non-homogenous lung injury. Three-level ventilation was defined as a type (modification of AV whose basic ventilation level was produced by the modes CMV, PCV or PS (ASB and add-on level, the so-called background ventilation was generated by two levels of PEEP. PEEP (constant and PEEPh (PEEP high with varying frequency and duration of transition between the individual levels of PEEP. Objective: to elucidate whether in cases of considerably non-homogenous gas distribution in acute pathological disorders, three-level ventilation (3LV can correct gas distribution into the so-called slow bronchoalveolar compartments, by decreasing the volume load of the so-called fast compartments and to improve lung gas exchange, by following the principles of safe ventilation. Results. 3LV was applied to 12 patients with severe non-homogenous lung injury/disorder (atypic pneumonia and ARDS/ALI and low-success PCV ventilation after recruitment manoeuvre (PaO2 (kPA /FiO2 = 5—6. There were pronounced positive changes in pulmonary gas exchange within 1—4 hours after initiation of 3LV at a fPCV of 26±4 breaths/min-1 and PEEPh at a fPEEPH of 7±2 breaths/min-1 with a minute ventilation of 12±4 l/min. 3LV reduced a intrapulmonary shunt fraction 50±5 to 30±5%, increased CO2 elimination, with PaCO2 falling to the values below 6±0.3 kPa, and PaO2 to 7.5±1.2 kPa, with FiO2 being decreased to 0.8—0.4. Lung recruitment also improved gas exchange: with PEEP=1.2±0.4 kPa, static tho-racopulmonary compliance (Cst elevated from 0.18±0.02 l/kPa to 0.3±0.02 l/kPa and then to 0.38±0.05 l/kPa. Airways resistance (Raw decreased by more than 30%. Improved lung aeration was also estimated as a manifestation of

Tudengiteatrite vaim ja vaev : üliõpilasteater peaks olema julgem: pole ju midagi kaotada, võita aga on palju / Rait Avestik

Index Scriptorium Estoniae

Avestik, Rait, 1974-

2006-01-01

17.-19. veebr. Viljandis toimunud üliõpilasteatrite festivalist, millest võtsid osa Tartu Üliõpilasteater : S. Kane "Puhastatud", lavastaja Kalev Kudu ; TÜ Pärnu kolledži üliõpilasteater K-äng2 : kohvikuprogramm "Maailma lõpus on kohvik" ; TÜ Viljandi Kultuuriakadeemia üliõpilased (mitte näitlejasuuna õppurid) : lavaline kompositsioon "Actus interruptus" ; Tallinna Tehnikaülikooli T-teater : Kurt Wonneguti "Õnne sünnipäevaks, Wanda June!", lavastaja Tamur Tohver ning Tallinna Ülikooli Tudengiteater : John Boynton Priestley "Nad tulid linna", lavastaja Juta Terali. Eraldi vaadeldakse TÜ Viljandi Kultuuriakadeemia 3. kursuse näitekunsti tudengite tööd : Dario Fo "Müsteerium Buff", lavastaja Peeter Raudsepp

Measurement of tidal volume using respiratory ultrasonic plethysmography in anaesthetized, mechanically ventilated horses.

Science.gov (United States)

Russold, Elena; Ambrisko, Tamas D; Schramel, Johannes P; Auer, Ulrike; Van Den Hoven, Rene; Moens, Yves P

2013-01-01

To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses. Prospective randomized experimental study. Five experimental horses. Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg(-1)) and positive end-expiratory pressures (PEEP) (0, 10, 20 cm H(2)O). Baseline ventilation mode (tidal volume=15 mL kg(-1), PEEP=0 cm H(2)O) was applied for 4 minutes between all treatments. Spirometry and RUP data were downloaded to personal computers. Linear regression analyses (RUP versus spirometric tidal volume) were performed using different subsets of data. Additonally RUP was calibrated against spirometry using a regression equation for all RUP signal values (thoracic, abdominal and combined) with all data collectively and also by an individually determined best regression equation (highest R(2)) for each experiment (horse versus recumbency) separately. Agreement between methods was assessed with Bland-Altman analyses. The highest correlation of RUP and spirometric tidal volume (R(2)=0.81) was found with the combined RUP signal in horses in lateral recumbency and ventilated without PEEP. The bias ±2 SD was 0±2.66 L when RUP was calibrated for collective data, but decreased to 0±0.87 L when RUP was calibrated with individual data. A possible use of RUP for tidal volume measurement during IPPV needs individual calibration to obtain limits of agreement within ±20%. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

[Effect of transpulmonary pressure-directed mechanical ventilation on respiration in severe acute pancreatitis patient with intraabdominal hypertension].

Science.gov (United States)

Wu, Xiaoyan; Zheng, Ruiqiang; Lin, Hua; Zhuang, Zhiqing; Zhang, Min; Yan, Peixia

2015-10-20

To assess the effect of mehanical ventilation (MV) guided by transpulmonary pressure (Ptp) on respiratory mechanics and gas exchange in severe acute pancreatitis patient with intraabdominal hypertension. Twelve severe acute pancreatitis patient with intraabdominal hypertension and acute respiratory distress syndrome(ARDS) underwent mechanical ventilation were involved from Jan to Dec 2013. PEEP levels were set to achieve a Ptp of 0 to 10 cm of water at end expiration. We also limited tidal volume to keep Ptp at less than 25 cm of water at end inspiration. Respiratory mechanics and gas-exchange were measured. Plat pressure (Pplat) increased and the compliance of chest wall (Ccw) decreased when intraabdominal pressure (IAP) increased. Pplat correlated with IAP positively (r2=0.741 9, P0.05). Compared with baseline, after guiding MV with Ptp, the Level of PEEP (14.6±4.2) cmH2O vs (8.3±2.0) cmH2O, and Ptp-e (1.5±0.5) cmH2O vs (-2.3±1.4) cmH2O increased (P0.05). Ptp-e correlated with PEEP (r2=0.549, P0.05). Compared with baseline, lung compliance (CL) (48.1±10.3) cmH2O vs (25.7±6.4) cmH2O and oxygenation index (PaO2/FiO2) (235±48) mmHg vs (160±35) mmHg improved obviously (P0.05). Transpulmonary pressure-directed mechanical ventilation in ARDS secondary to severe acute pancreatitis patient with intraabdominal hypertension could not only recruit the collapsed alveoli, improve lung compliance, increase oxygenation index and decrease dead space ventilation but also monitor lung stress to avoid alveoli overinflation, which might be lung protective.

Pneumoperitoneum deteriorates intratidal respiratory system mechanics: an observational study in lung-healthy patients.

Science.gov (United States)

Wirth, Steffen; Biesemann, Andreas; Spaeth, Johannes; Schumann, Stefan

2017-02-01

Pneumoperitoneum during laparoscopic surgery leads to atelectasis and impairment of oxygenation. Positive end-expiratory pressure (PEEP) is supposed to counteract atelectasis. We hypothesized that the derecruiting effects of pneumoperitoneum would deteriorate the intratidal compliance profile in patients undergoing laparoscopic surgery. In 30 adult patients scheduled for surgery with pneumoperitoneum, respiratory variables were measured during mechanical ventilation. We calculated the dynamic compliance of the respiratory system (C RS ) and the intratidal volume-dependent C RS curve using the gliding-SLICE method. The C RS curve was then classified in terms of indicating intratidal recruitment/derecruitment (increasing profile) and overdistension (decreasing profile). During the surgical interventions, the PEEP level was maintained nearly constant at 7 cm H 2 O. Data are expressed as mean [confidence interval]. Baseline C RS was 60 [54-67] mL cm H 2 O -1 . Application of pneumoperitoneum decreased C RS to 40 [37-43] mL cm H 2 O -1 which partially recovered to 54 [50-59] mL cm H 2 O -1 (P < 0.001) after removal but remained below the value measured before pneumoperitoneum (P < 0.001). Baseline compliance profiles indicated intratidal recruitment/derecruitment in 48 % patients. After induction of pneumoperitoneum, intratidal recruitment/derecruitment was indicated in 93 % patients (P < 0.01), and after removal intratidal recruitment/derecruitment was indicated in 59 % patients. Compliance profiles showing overdistension were not observed. Analyses of the intratidal compliance profiles reveal that pneumoperitoneum during laparoscopic surgery causes intratidal recruitment/derecruitment which partly persists after its removal. The analysis of the intratidal volume-dependent C RS profiles could be used to guide intraoperative PEEP adjustments during elevated intraabdominal pressure.

Respiratory Management of Perioperative Obese Patients.

Science.gov (United States)

Imber, David Ae; Pirrone, Massimiliano; Zhang, Changsheng; Fisher, Daniel F; Kacmarek, Robert M; Berra, Lorenzo

2016-12-01

With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique. Although strong evidence and research are lacking regarding how to best ventilate the obese surgical patient, we aim with this review to provide an assessment of the small amount of research that has been conducted and the pathophysiology we believe influences the apparent results. We will provide a basic overview of the anatomy and pathophysiology of the obese respiratory system and review studies concerning pre-, intra-, and postoperative respiratory care. Our focus in this review centers on the best approach to keeping the lung recruited through the prevention of compression atelectasis and the maintaining of physiological lung volumes. We recommend the use of PEEP via noninvasive ventilation (NIV) before induction and endotracheal intubation, the use of both PEEP and periodic recruitment maneuvers during mechanical ventilation, and the use of PEEP via NIV after extubation. It is our hope that by studying the underlying mechanisms that make ventilating obese patients so difficult, future research can be better tailored to address this increasingly important challenge to the field of anesthesia. Copyright © 2016 by Daedalus Enterprises.

Yli 100 syytä mennä Viroon / Terhi Pääskylä-Malmström

Index Scriptorium Estoniae

Pääskylä-Malmström, Terhi, 1979-

2015-01-01

Tutvustus: Did you know that there are over 100 exciting, quirky, unique and important reasons to visit Estonia! = Tiesitkö että on yli 100 jännittävää, outoa, ainutlaatuista ja tärkeää syytä tulla Viroon? / koostanud Jussi-Pekka Aukia, Peep Ehasalu. Tallinn : AS Sokotel, 2015

Suurfirmade 2008. aasta eelarved kinnitavad majanduse jahtumist / Mikk Salu

Index Scriptorium Estoniae

Salu, Mikk, 1975-

2008-01-01

Eesti suurettevõtete juhid räägivad, kuidas nad oma ettevõtte uue aasta eelarvet on planeerinud, kui palju on arvestanud palgakasvuks. Pindi Kinnisvara arvestab oma tulude 20-protsendilise langusega. Peep Sooman, Enn Saar, Vahur Roossaar, Tarmo Noop, Siim Kallast ja Meelis Milder vastavad küsimusele, millist palgatõusu nad prognoosivad 2008. aastal

Tallinna linn või aukude plombeerimine = City of Tallinn or filling of holes / Veljo Kaasik

Index Scriptorium Estoniae

Kaasik, Veljo

1999-01-01

"Eesti Päevalehes" ilmunud arhitektide viimase aja karakteersemate tööde hindamistabelist, selles olevast Nissani keskusest (Andres Siim, Hanno Kreis), Hansapanga hoonest ja Stockmanni kaubamajast (Peep Jänes). Tallinna arhitektuurist kui tervikust. Tallinnas on palju tühje krunte, rekonstrueerimist ootavaid linnaosi ja suuri üksikhooneid. Linn realiseerub läbi investorite majandusliku huvitatuse

Multifilm kui tõsine asi / Marko Mägi

Index Scriptorium Estoniae

Mägi, Marko

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Eesti animafilme igale maitsele / Sulev Teinemaa

Index Scriptorium Estoniae

Teinemaa, Sulev, 1947-

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Aimdusi tsivilisatsioonist / Tarmo Teder

Index Scriptorium Estoniae

Teder, Tarmo, 1958-

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Animaalselt ja humaanselt / Karlo Funk

Index Scriptorium Estoniae

Funk, Karlo, 1971-

1998-01-01

Esilinastus 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

The effect of lung deflation on the position of the pleura during subclavian vein cannulation in infants receiving mechanical ventilation: an ultrasound study.

Science.gov (United States)

Jang, Y-E; Lee, J-H; Park, Y-H; Byon, H-J; Kim, H-S; Kim, C-S; Kim, J-T

2013-10-01

We evaluated the effect of lung deflation on the relative position of the pleura compared with a reference line during supra- and infraclavicular approaches to the right subclavian vein. The reference line was drawn relative to the predicted pathway of the needle. The distances between the pleura and the reference line for supra- and infraclavicular approaches were measured during inspiration and expiration in 41 infants. Measurements were repeated with the application of 5 cmH2O positive end-expiratory pressure (PEEP) and in the Trendelenburg position. Lung deflation during the supraclavicular approach significantly decreased the volume of lung crossing the reference line by a median (IQR [range]) of 1.0 (0.6 to 1.3 [0.0 to 4.8]) mm, p deflation showed no change in the distance of the pleura from the reference line regardless of PEEP or patient position. We conclude that lung deflation moves the lung apex caudally and can reduce the potential risk of pneumothorax during a supraclavicular approach to the right subclavian vein in infants. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Effects of positive end-expiratory pressure on arthroscopic shoulder surgery under general anesthesia.

Science.gov (United States)

Ersoy, Ayşın; Çakırgöz, Mensure; Ervatan, Zekeriya; Kıran, Özlem; Türkmen, Aygen; Esenyel, Cem Zeki

2016-01-01

Our study is a prospective, randomized study on patients undergoing arthroscopic shoulder surgery in the beach-chair position to evaluate the effects of positive end-expiratory pressure (PEEP) on hemodynamic stability, providing a bloodless surgical field and surgical satisfaction. Fifty patients were divided into two groups. Group I (n=25) had zero end-expiratory pressure (ZEEP) administered under general anesthesia, and group II (n=25) had +5 PEEP administered. During surgery, intraarticular hemorrhage and surgical satisfaction were evaluated on a scale of 0-10. During surgery, at the 5th, 30th, 60th, and 90th minutes and at the end of surgery, heart rate, mean arterial pressure (MAP), and positive inspiratory pressure were recorded. At the end of the surgery, the amount of bleeding and duration of the operation were recorded. In group I, the duration of operation and amount of bleeding were found to be significantly greater than those in group II (pshoulder surgery in the beach-chair position reduces the amount of hemorrhage in the surgical field and thus increases surgical satisfaction without requiring the creation of controlled hypotension.

USA presidendivalimised lükati käima / Kalev Kask

Index Scriptorium Estoniae

Kask, Kalev

2007-01-01

Kuigi USA presidendi George Walker Bushi ametiaeg lõpeb kahe aasta pärast ja presidendivalimised toimuvad alles järgmisel aastal, on valimiskampaania juba alanud. Esmalt tuleb vabariiklastel ja demokraatidel välja selgitada partei ühiskandidaadid

Tegevusloa kehtetuks tunnistamine : kas haldussund või karistus? / Kalev Aavik

Index Scriptorium Estoniae

Aavik, Kalev

2011-01-01

Artikkel põhineb 31. Eesti õigusteadlaste päevadel Tartus 30. septembril 2010 peetud ettekandel. 23. veebruaril 2011 võttis Riigikogu vastu majandustegevuse seadustiku üldosa seaduse, mis muuhulgas kodifitseerib tegevuslubade andmise ja kehtetuks tunnistamise normid. Vastavast Euroopa Inimõiguste Kohtu praktikast

Et karu müttaks ja hunt uluks / Kalev Aun

Index Scriptorium Estoniae

Aun, Kalev, 1951-

2004-01-01

Keskkonnainvesteeringute Keskuse jahinduse programmi raames toetab KIK jahimaade korralduse ja ulukikaitse projekte ning jahiulukite rakendusuuringuid, trükiste väljaandmist ja jahimeeste erialast väljaõpet

Vastutegevuse staabi tööst Kevadtormil 2003 / Kalev Muru

Index Scriptorium Estoniae

Muru, Kalev

2003-01-01

Brigaadiõppustel Kevadtorm 2003 võimaldati reservohvitseridel soovi korral osaleda Kaitseliidu üksuste juures abilistena. Kaitseliit oli sellel suurõppusel üks põhilisi vastutegevuse organiseerijaid

Seitsmes palverändur on professor Volker Sellin / Kalev Vilgats

Index Scriptorium Estoniae

Vilgats, Kalev

2009-01-01

Pärnust pärit valgustusaja mõtleja Carl Gustav Jochmanni 220. sünniaastapäeva tähistamine Pärnu raekojas. Loenguid pidasid professorid dr. Ulrich Kronauer ja dr. Volker Sellin Saksamaalt. Seitsmenda Pärnu akadeemilise palveränduri märgi sai dr. Volker Sellin. Akadeemilise palverändurimärgi on saanud väljaspool Eestit Pärnu ajaloo uurimist toetanud või siit pärit väljapaistvate tegelaste pärandit tutvustanud õpetlased

A-, B- ja C-kingades üle salamandrite / Kalev Vapper

Index Scriptorium Estoniae

Vapper, Kalev, 1982-

2010-01-01

Fotonäitus "Riburajad" Y-galeriis Tartus 5. oktoobrist 17. oktoobrini 2009, kuraator Peeter Laurits. Näitusel eksponeeritud fotode read tekkisid järk-järgult pildivahetuse käigus Tartu Kõrgema Kunstikooli endiste ja praeguste tudengite vahel. Loetletud osalejad, lähemalt Valdur Mikita tekstidest

Летняя кухня - функционально и красиво / Тийна Кольк

Index Scriptorium Estoniae

Кольк, Тийна

2010-01-01

Valik arhitektuurikonkursile "Väike 2007-2009" esitatud väikeobjektidest. Korvamäe suveköök (Urmas Muru, Peeter Pere, Reet Viigipuu, Karl Õiger), Mähe puhkemaja väliköök (Emil Urbel, Indrek Erm), aiamaja Pelgulinnas (Madis Eek), Suurupi aiapaviljon (Peep Roosmann), Tabasalu vaskeramu grillikoht (Urmas Muru, Peeter Pere, Anna-Maria Erik, Ago Kuddu)

Grillipaviljon, väliköök, varjualune... / Tiina Kolk

Index Scriptorium Estoniae

Kolk, Tiina

2010-01-01

Tutvustatakse valikut arhitektuurikonkursile "Väike 2007-2009" esitatud õueobjektidest. Suurupi aiapaviljon (Peep Roosmann), aiamaja Pelgulinnas (Madis Eek), Mähe puhkemaja väliköök (Emil Urbel, Indrek Erm), Korvamäe suveköök (Urmas Muru, Peeter Pere, Reet Viigipuu, Karl Õiger), Tabasalu vaskeramu grillikoht (Urmas Muru, Peeter Pere, Anna-Maria Erik, Ago Kuddu)

Ilo Pariisi varjus / Kaia Sisask

Index Scriptorium Estoniae

Sisask, Kaia

2003-01-01

Portreefilm Pariisis giidina töötavast kirjanik Juhan Jaigi tütrest Ilo Jaik-Riedbergist "Ilo Pariisis" : stsenarist ja režissöör Peep Puks : operaatorid Arvo Vilu, Ago Ruus, Heli Arvo Vilu, Henn Liiva, Jüri Vaher : teksti loeb Anu Lamp : muusikaline kujundus Merike Vaino : filmi direktor Maie Kerma : Pro-Film 2002

Torontos peeti eesti dokfilmifestivali "Estdoc's" / Olev Remsu

Index Scriptorium Estoniae

Remsu, Olev, 1947-

2006-01-01

Toronto eesti dokumentaalfilmide festival "Estdoc's". Demonstreeriti filme: "Sinimäed" (Raimo Jõerand), "Tiim" (Peep Puks), "Mikk" (Rein Raamat, Peeter Brambat), "6 tundi" (Rein Kotov), "Erna retk" (Vaado Sarapuu), "Tõrjutud mälestused" (Imbi Paju), "Middendorfi jälgedes" (Riho Västrik), "Mehed unustatud armeest" (Indrek Treufeldt), "Nagu noor jumal" ja "Orjus Eestis" (mõlema autor Olev Remsu)

Afbrydelsens kronotopi i britisk litteratur, 1840-1870

DEFF Research Database (Denmark)

Damkjær, Maria

2017-01-01

-1866), combined with a new historicist reading of Victorian advice literature, this article argues that narrative marginalisation was paradoxically a viable strategy for showing an otherwise invisible temporality. In the background, peeping out whenever the plot interrupts, is an enduring and ongoing time......, mediated by unnamed and underrepresented servants, that gives the middle-class home temporal depth and realism....

Animatsiooni vastu ei saa ükski / Mikk Rand

Index Scriptorium Estoniae

Rand, Mikk, 1970-

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Esilinastuvad eesti animafilmid

Index Scriptorium Estoniae

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Kuus uut Eesti filmi korraga ekraanil / Tarmo Teder

Index Scriptorium Estoniae

Teder, Tarmo, 1958-

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer

Ventilator-induced mediator release: role of PEEP and surfactant

OpenAIRE

Haitsma, Jack

2002-01-01

textabstractLung protective ventilation such as the ARDSnet low tidal volumes strategy can reduce mortality in ARDS patients. The lmowledge that an essential therapy such as mechanical ventilation on the intensive care influences patient outcome has given rise to the re-evaluation of current ventilation practices. This review addresses the current state of lung protective strategies and their physiological rationale. Latest knowledge on the instigation and progression of lung injury by mechan...

Loe raha, ole paindlik ning kuula klienti / Peep Ehasalu

Index Scriptorium Estoniae

Ehasalu, Peep, 1966-

2004-01-01

Eesti ettevõtete TOP 100 1. koht. Kolmandat aastat järjest edetabeli tippu jõudnud Tele2 edu rajaneb kolmel sambal. Lisad: Tele2 Eesti AS; Tele2 pürgib maruliselt kõrgustesse. Kommenteerivad Andrus Hiiepuu, Inna Kramer ja Agne Kivisaar.

Ettevaatust, bussid jäävad seisma! / Peep Peterson

Index Scriptorium Estoniae

Peterson, Peep, 1975-

2004-01-01

Ilmunud ka: Severnoje Poberezhje, 23. okt. 2004, lk. 2; Narva Postiljon, 23. okt. 2004, lk. 5; Narvskaja Gazeta, 23. okt. 2004, lk. 4; Sakala, 26. okt. 2004, lk. 2; Võrumaa Teataja, 26. okt. 2004, lk. 2; Vooremaa, 26. okt. 2004, lk. 2; Meie Maa, 26. okt. 2004, lk. 2; Harjumaa, 26. okt. 2004, lk. 2; Järva Teataja, 28. okt. 2004, lk. 2; Hiiu Leht, 29. okt. 2004, lk. 2; Pärnu Postimees, 29. okt. 2004, lk. 15; Linnaleht : Pärnu, 29. okt. 2004, lk. A4; Valgamaalane, 6. nov. 2004, lk. 2. Transpordi ametiühing andis autoettevõtete liidule üle nõudmise, milles taotleb kõigile bussijuhtidele lisatasudeta Eesti keskmist palka. Kokkuleppele tuleb jõuda enne 2005. aasta 1. jaanuari

Kuidas kirjutada eesti rahva vastupanust okupatsioonivõimudele? / Peep Varju

Index Scriptorium Estoniae

Varju, Peep

2009-01-01

Eestlaste vastupanust Teise maailmasõja ajal, ajalootõlgendusest taasiseseisvumise esimestel aastatel. Ettekanne Jüri Kuke mälestusele pühendatud Langenud Vabadusvõitlejate Päeva XIII aulakonverentsil Tartu Ülikoolis 28. märtsil 2009

Sõjakurjategijate ja nende ohvrite kohtlemisest Eesti Vabariigis / Peep Varju

Index Scriptorium Estoniae

Varju, Peep

2009-01-01

Autor kritiseerib 1949. aasta märtsiküüditamises kannatanute võimalusi õigusabile ja küüditajate üle kohtumõistmise venimist. Viited okupatsioonirežiimide poolt represseeritud isiku seadusele

Kolmepoolne koostöölepe Tehnikaülikooli, OÜ TTÜ Sport ja SEB Ühispanga vahel

Index Scriptorium Estoniae

2006-01-01

Tallinna Tehnikaülikool rektor Peep Sürje, Osaühing TTÜ Sport juhatuse esimees Andres Öpik ja AS SEB Eesti Ühispank juhatuse esimees Mart Altvee allkirjastasid kolmepoolse koostöölepingu, milles nähakse ette ühistegevused TTÜ üliõpilastele õppekavadega seotud äriplaanikonkursi korraldamisel, üliõpilaste sporditegevuse edasiarendamisel ning üliõpilastele osutatud pangateenuste parandamisel

Eesti täispikad dokumentaalfilmid 2005. aastal / Marianne Kõrver

Index Scriptorium Estoniae

Kõrver, Marianne, 1980-

2006-01-01

Portreefilmid : Priit Pärnast "Pärnograafia" (Hardi Volmer), Ivar Heinmaast "Kutse" (Peep Puks), Veljo Tormisest "Tormise regi" (Sulev Keedus), Rein Tammikust "Teekond ruudulisel laudlinal" (Peeter Urbla), "Afanassi" (Liina Trishkina) ; probleemfilmid : "Parema elu nimel" (Märt Sildvee), "Piisa torn" (Arko Okk) ; sõjateemalised dokumentaalid : "Afganistani armid" (Ivar Heinmaa), "Hauka grupp" (Rene Vilbre), "Tõrjutud mälestused" (Imbi Paju) ; loodusfilm "Eesti kotkad" (Rein Maran)

Suur esilinastamine

Index Scriptorium Estoniae

1998-01-01

21.5. esilinastuvad kinos "Sõprus" 6 animafilmi : "Vares ja hiired", autorid Priit Tender ja Mikk Rand; "Just märried", autor Peep Pedmanson; "Päevavalgus", autor Mait Laas; "Tom ja Fluffy", režissöörid Janno Põldma ja Heiki Ernits; "Bermuda", autor Ülo Pikkov; "Primavera", režissöörid Riho Unt ja Hardi Volmer. Aut. : M.R

Mäss Norma pardal / Annika Matson, Katre Pilvinski

Index Scriptorium Estoniae

Matson, Annika, 1976-

2008-01-01

Norma väikeaktsionärid nõuavad Norma juhilt Peep Siimonilt suuremat dividendi ja et ettevõte ostaks neilt kuni kümnendiku aktsiaid tagasi turuhinnast ligi kaks korda kõrgema hinnaga. Diagramm: Norma dividendimaksed. Kommenteerib Sander Danil. Vt. ka Enn Tossi art. "Norma tegevus ajab väikeaktsionäri vihale" Äripäev 8. mai lk. 3

Väike luulekaleidoskoop. III / Jürgen Rooste

Index Scriptorium Estoniae

Rooste, Jürgen, 1979-

2009-01-01

Ülevaade järgmistest luuleraamatutest: Anmann, Aarne. Südametunnistuse mälestuseks. Tartu : A. Anmann, 2009 ; Ilmet, Peep. Meilmail. Tallinn : Varrak, 2009 ; Kasemaa, Andrus. Lagunemine. Tallinn : Eesti Keele Sihtasutus, 2009 ; Kuus, Anti ; Oll, Sulev. Öö mõte on kuus. Tallinn : Akta A. K., 2008 ; Meres, Triinu. Lagunemine. Tartu : Hermes, 2009 ; Tasuja, Triin. Provintsiluule. Tartu : Värske Rõhk, 2009

Lung-protective ventilation in abdominal surgery.

Science.gov (United States)

Futier, Emmanuel; Jaber, Samir

2014-08-01

To provide the most recent and relevant clinical evidence regarding the use of prophylactic lung-protective mechanical ventilation in abdominal surgery. Evidence is accumulating, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary complications in patients undergoing abdominal surgery. Nonprotective ventilator settings, especially high tidal volume (>10-12 ml/kg), very low level of positive end-expiratory pressure (PEEP, ventilator-associated lung injury in patients with healthy lungs. Stimulated by the previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung-protective mechanical ventilation. Recent data provide compelling evidence that prophylactic lung-protective mechanical ventilation using lower tidal volume (6-8 ml/kg of predicted body weight), moderate PEEP (6-8 cm H2O), and recruitment maneuvers is associated with improved functional or physiological and clinical postoperative outcome in patients undergoing abdominal surgery. The use of prophylactic lung-protective ventilation can help in improving the postoperative outcome.

Time course of lung inflammatory and fibrogenic responses during protective mechanical ventilation in healthy rats.

Science.gov (United States)

Krebs, Joerg; Pelosi, Paolo; Tsagogiorgas, Charalambos; Haas, Jenny; Yard, Benito; Rocco, Patricia R M; Luecke, Thomas

2011-09-15

This study aimed to assess pulmonary inflammatory and fibrogenic responses and their impact on lung mechanics and histology in healthy rats submitted to protective mechanical ventilation for different experimental periods. Eighteen Wistar rats were randomized to undergo open lung-mechanical ventilation (OL-MV) for 1, 6 or 12 h. Following a recruitment maneuver, a decremental PEEP trial was performed and PEEP set according to the minimal respiratory system static elastance. Respiratory system, lung, and chest-wall elastance and gas-exchange were maintained throughout the 12 h experimental period. Histological lung injury score remained low at 1 and 6 h, but was higher at 12 h due to overinflation. A moderate inflammatory response was observed with a distinct peak at 6h. Compared to unventilated controls, type I procollagen mRNA expression was decreased at 1 and 12h, while type III procollagen expression decreased throughout the 12h experimental period. In conclusion, OL-MV in healthy rats yielded overinflation after 6 h even though respiratory elastance and gas-exchange were preserved for up to 12 h. Copyright © 2011 Elsevier B.V. All rights reserved.

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study.

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM.

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study* **

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Objective: Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. Methods: This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Results: Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. Conclusions: The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM. PMID:25029653

Personalizing mechanical ventilation for acute respiratory distress syndrome

OpenAIRE

Berngard, S. Clark; Beitler, Jeremy R.; Malhotra, Atul

2016-01-01

Lung-protective ventilation with low tidal volumes remains the cornerstone for treating patient with acute respiratory distress syndrome (ARDS). Personalizing such an approach to each patient's unique physiology may improve outcomes further. Many factors should be considered when mechanically ventilating a critically ill patient with ARDS. Estimations of transpulmonary pressures as well as individual's hemodynamics and respiratory mechanics should influence PEEP decisions as well as response ...

Ground water in Delhi area, problems and prospects under fast urbanisation- a nuclear aided study

International Nuclear Information System (INIS)

Mookerjee, P.; Datta, P.S.; Chandrasekharan, H.; Tyagi, S.K.; Singh, R.V.

1994-01-01

The work presented in this paper constitutes a peep into the components of urbanization in the two decades which affected the quality and availability of ground water in the Delhi territory. The recharge studies conducted in Delhi villages employing oxygen 18 and tritium tagging have been described with a view to focus attention on the sustainability of the ground water potential. 1 fig., 1 tab

Seitse raamatut ühtmoodi loodusest, kuid kõik erinevad / Ulvar Käärt, Mari Klein

Index Scriptorium Estoniae

Käärt, Ulvar, 1982-

2009-01-01

Arvustus: Järva, Jaanus. Looduse aasta. Tallinn : Varrak, 2008; Järva, Jaanus. Raba : vaikuses ja varjus. Tallinn : Pegasus, 2008; Savisaar, Remo. Loodus kutsub. Tallinn : Varrak, 2008; Relve, Hendrik. Eesti looduse vägi. Tallinn : Koolibri, 2008; Tartes, Urmas, Põder, Jaak. Legendiloomad. Tallinn : Varrak, 2008; Eesti maastikud. Tallinn : Tänapäev, 2008; Veedla, Peep. Lindudega sõbraks / pildid joonistanud Triinu Ootsing. Tallinn : Berit Grupp, 2008

Nanotoxicity comparison of four amphiphilic polymeric micelles with similar hydrophilic or hydrophobic structure.

Science.gov (United States)

Zhao, Bo; Wang, Xue-Qing; Wang, Xiao-You; Zhang, Hua; Dai, Wen-Bing; Wang, Jun; Zhong, Zhen-Lin; Wu, Hou-Nan; Zhang, Qiang

2013-10-03

Nanocarriers represent an attractive means of drug delivery, but their biosafety must be established before their use in clinical research. Four kinds of amphiphilic polymeric (PEG-PG-PCL, PEEP-PCL, PEG-PCL and PEG-DSPE) micelles with similar hydrophilic or hydrophobic structure were prepared and their in vitro and in vivo safety were evaluated and compared. In vitro nanotoxicity evaluations included assessments of cell morphology, cell volume, inflammatory effects, cytotoxicity, apoptosis and membrane fluidity. An umbilical vein cell line (Eahy.926) and a kind of macrophages (J774.A1) were used as cell models considering that intravenous route is dominant for micelle delivery systems. In vivo analyses included complete blood count, lymphocyte subset analysis, detection of plasma inflammatory factors and histological observations of major organs after intravenous administration to KM mice. All the micelles enhanced inflammatory molecules in J774.A1 cells, likely resulting from the increased ROS levels. PEG-PG-PCL and PEEP-PCL micelles were found to increase the J774.A1 cell volume. This likely correlated with the size of PEG-PG-PCL micelles and the polyphosphoester structure in PEEP-PCL. PEG-DSPE micelles inhibited the growth of Eahy.926 cells via inducing apoptosis. This might relate to the structure of DSPE, which is a type of phospholipid and has good affinity with cell membrane. No evidence was found for cell membrane changes after treatment with these micelles for 24 h. In the in vivo study, during 8 days of 4 time injection, each of the four nanocarriers altered the hematic phase differently without changes in inflammatory factors or pathological changes in target organs. These results demonstrate that the micelles investigated exhibit diverse nanotoxicity correlated with their structures, their biosafety is different in different cell model, and there is no in vitro and in vivo correlation found. We believe that this study will certainly provide more

Modes of mechanical ventilation for the operating room.

Science.gov (United States)

Ball, Lorenzo; Dameri, Maddalena; Pelosi, Paolo

2015-09-01

Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis. Non-invasive positive pressure ventilation delivered through different interfaces should be considered at the induction of anaesthesia morbidly obese patients. Anaesthesia ventilators are becoming increasingly sophisticated, integrating many functions that were once exclusive to intensive care. Modern anaesthesia machines provide high performances in delivering the desired volumes and pressures accurately and precisely, including assisted ventilation modes. Therefore, the physicians should be familiar with the potential and pitfalls of the most commonly used intraoperative ventilation modes: volume-controlled, pressure-controlled, dual-controlled and assisted ventilation. Although there is no clear evidence to support the advantage of any one of these ventilation modes over the others, protective mechanical ventilation with low tidal volume and low levels of positive end-expiratory pressure (PEEP) should be considered in patients undergoing surgery. The target tidal volume should be calculated based on the predicted or ideal body weight rather than on the actual body weight. To optimize ventilation monitoring, anaesthesia machines should include end-inspiratory and end-expiratory pause as well as flow-volume loop curves. The routine administration of high PEEP levels should be avoided, as this may lead to haemodynamic impairment and fluid overload. Higher PEEP might be considered during surgery longer than 3 h

Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study.

Science.gov (United States)

Ladha, Karim; Vidal Melo, Marcos F; McLean, Duncan J; Wanderer, Jonathan P; Grabitz, Stephanie D; Kurth, Tobias; Eikermann, Matthias

2015-07-14

To evaluate the effects of intraoperative protective ventilation on major postoperative respiratory complications and to define safe intraoperative mechanical ventilator settings that do not translate into an increased risk of postoperative respiratory complications. Hospital based registry study. Academic tertiary care hospital and two affiliated community hospitals in Massachusetts, United States. 69,265 consecutively enrolled patients over the age of 18 who underwent a non-cardiac surgical procedure between January 2007 and August 2014 and required general anesthesia with endotracheal intubation. Protective ventilation, defined as a median positive end expiratory pressure (PEEP) of 5 cmH2O or more, a median tidal volume of less than 10 mL/kg of predicted body weight, and a median plateau pressure of less than 30 cmH2O. Composite outcome of major respiratory complications, including pulmonary edema, respiratory failure, pneumonia, and re-intubation. Of the 69,265 enrolled patients 34,800 (50.2%) received protective ventilation and 34,465 (49.8%) received non-protective ventilation intraoperatively. Protective ventilation was associated with a decreased risk of postoperative respiratory complications in multivariable regression (adjusted odds ratio 0.90, 95% confidence interval 0.82 to 0.98, P=0.013). The results were similar in the propensity score matched cohort (odds ratio 0.89, 95% confidence interval 0.83 to 0.97, P=0.004). A PEEP of 5 cmH2O and median plateau pressures of 16 cmH2O or less were associated with the lowest risk of postoperative respiratory complications. Intraoperative protective ventilation was associated with a decreased risk of postoperative respiratory complications. A PEEP of 5 cmH2O and a plateau pressure of 16 cmH2O or less were identified as protective mechanical ventilator settings. These findings suggest that protective thresholds differ for intraoperative ventilation in patients with normal lungs compared with those used for patients

Evaluating the effects of protective ventilation on organ-specific cytokine production in porcine experimental postoperative sepsis.

Science.gov (United States)

Sperber, Jesper; Lipcsey, Miklós; Larsson, Anders; Larsson, Anders; Sjölin, Jan; Castegren, Markus

2015-05-10

Protective ventilation with lower tidal volume (VT) and higher positive end-expiratory pressure (PEEP) reduces the negative additive effects of mechanical ventilation during systemic inflammatory response syndrome. We hypothesised that protective ventilation during surgery would affect the organ-specific immune response in an experimental animal model of endotoxin-induced sepsis-like syndrome. 30 pigs were laparotomised for 2 hours (h), after which a continuous endotoxin infusion was started at 0.25 micrograms × kg(-1) × h(-1) for 5 h. Catheters were placed in the carotid artery, hepatic vein, portal vein and jugular bulb. Animals were randomised to two protective ventilation groups (n = 10 each): one group was ventilated with VT 6 mL × kg(-1) during the whole experiment while the other group was ventilated during the surgical phase with VT of 10 mL × kg(-1). In both groups PEEP was 5 cmH2O during surgery and increased to 10 cmH2O at the start of endotoxin infusion. A control group (n = 10) was ventilated with VT of 10 mL × kg(-1) and PEEP 5 cm H20 throughout the experiment. In four sample locations we a) simultaneously compared cytokine levels, b) studied the effect of protective ventilation initiated before and during endotoxemia and c) evaluated protective ventilation on organ-specific cytokine levels. TNF-alpha levels were highest in the hepatic vein, IL-6 levels highest in the artery and jugular bulb and IL-10 levels lowest in the artery. Protective ventilation initiated before and during endotoxemia did not differ in organ-specific cytokine levels. Protective ventilation led to lower levels of TNF-alpha in the hepatic vein compared with the control group, whereas no significant differences were seen in the artery, portal vein or jugular bulb. Variation between organs in cytokine output was observed during experimental sepsis. We see no implication from cytokine levels for initiating protective ventilation before endotoxemia. However, during endotoxemia

Application of mid-frequency ventilation in an animal model of lung injury: a pilot study.

Science.gov (United States)

Mireles-Cabodevila, Eduardo; Chatburn, Robert L; Thurman, Tracy L; Zabala, Luis M; Holt, Shirley J; Swearingen, Christopher J; Heulitt, Mark J

2014-11-01

Mid-frequency ventilation (MFV) is a mode of pressure control ventilation based on an optimal targeting scheme that maximizes alveolar ventilation and minimizes tidal volume (VT). This study was designed to compare the effects of conventional mechanical ventilation using a lung-protective strategy with MFV in a porcine model of lung injury. Our hypothesis was that MFV can maximize ventilation at higher frequencies without adverse consequences. We compared ventilation and hemodynamic outcomes between conventional ventilation and MFV. This was a prospective study of 6 live Yorkshire pigs (10 ± 0.5 kg). The animals were subjected to lung injury induced by saline lavage and injurious conventional mechanical ventilation. Baseline conventional pressure control continuous mandatory ventilation was applied with V(T) = 6 mL/kg and PEEP determined using a decremental PEEP trial. A manual decision support algorithm was used to implement MFV using the same conventional ventilator. We measured P(aCO2), P(aO2), end-tidal carbon dioxide, cardiac output, arterial and venous blood oxygen saturation, pulmonary and systemic vascular pressures, and lactic acid. The MFV algorithm produced the same minute ventilation as conventional ventilation but with lower V(T) (-1 ± 0.7 mL/kg) and higher frequency (32.1 ± 6.8 vs 55.7 ± 15.8 breaths/min, P ventilation and MFV for mean airway pressures (16.1 ± 1.3 vs 16.4 ± 2 cm H2O, P = .75) even when auto-PEEP was higher (0.6 ± 0.9 vs 2.4 ± 1.1 cm H2O, P = .02). There were no significant differences in any hemodynamic measurements, although heart rate was higher during MFV. In this pilot study, we demonstrate that MFV allows the use of higher breathing frequencies and lower V(T) than conventional ventilation to maximize alveolar ventilation. We describe the ventilatory or hemodynamic effects of MFV. We also demonstrate that the application of a decision support algorithm to manage MFV is feasible. Copyright © 2014 by Daedalus Enterprises.

Bench evaluation of 7 home-care ventilators.

Science.gov (United States)

Blakeman, Thomas C; Rodriquez, Dario; Hanseman, Dennis; Branson, Richard D

2011-11-01

Portable ventilators continue to decrease in size while increasing in performance. We bench-tested the triggering, battery duration, and tidal volume (V(T)) of 7 portable ventilators: LTV 1000, LTV 1200, Puritan Bennett 540, Trilogy, Vela, iVent 101, and HT50. We tested triggering with a modified dual-chamber test lung to simulate spontaneous breathing with weak, normal, and strong inspiratory effort. We measured battery duration by fully charging the battery and operating the ventilator with a V(T) of 500 mL, a respiratory rate of 20 breaths/min, and PEEP of 5 cm H(2)O until breath-delivery ceased. We tested V(T) accuracy with pediatric ventilation scenarios (V(T) 50 mL or 100 mL, respiratory rate 50 breaths/min, inspiratory time 0.3 s, and PEEP 5 cm H(2)O) and an adult ventilation scenario (V(T) 400 mL, respiratory rate 30 breaths/min, inspiratory time 0.5 s, and PEEP 5 cm H(2)O). We measured and analyzed airway pressure, volume, and flow signals. At the adult settings the measured V(T) range was 362-426 mL. On the pediatric settings the measured V(T) range was 51-182 mL at the set V(T) of 50 mL, and 90-141 mL at the set V(T) of 100 mL. The V(T) delivered by the Vela at both the 50 mL and 100 mL, and by the HT50 at 100 mL, did not meet the American Society for Testing and Materials standard for V(T) accuracy. Triggering response and battery duration ranged widely among the tested ventilators. There was wide variability in battery duration and triggering sensitivity. Five of the ventilators performed adequately in V(T) delivery across several settings. The combination of high respiratory rate and low V(T) presented problems for 2 of the ventilators.

Mechanical breath profile of airway pressure release ventilation: the effect on alveolar recruitment and microstrain in acute lung injury.

Science.gov (United States)

Kollisch-Singule, Michaela; Emr, Bryanna; Smith, Bradford; Roy, Shreyas; Jain, Sumeet; Satalin, Joshua; Snyder, Kathy; Andrews, Penny; Habashi, Nader; Bates, Jason; Marx, William; Nieman, Gary; Gatto, Louis A

2014-11-01

Improper mechanical ventilation settings can exacerbate acute lung injury by causing a secondary ventilator-induced lung injury. It is therefore important to establish the mechanism by which the ventilator induces lung injury to develop protective ventilation strategies. It has been postulated that the mechanism of ventilator-induced lung injury is the result of heterogeneous, elevated strain on the pulmonary parenchyma. Acute lung injury has been associated with increases in whole-lung macrostrain, which is correlated with increased pathology. However, the effect of mechanical ventilation on alveolar microstrain remains unknown. To examine whether the mechanical breath profile of airway pressure release ventilation (APRV), consisting of a prolonged pressure-time profile and brief expiratory release phase, reduces microstrain. In a randomized, nonblinded laboratory animal study, rats were randomized into a controlled mandatory ventilation group (n = 3) and an APRV group (n = 3). Lung injury was induced by polysorbate lavage. A thoracotomy was performed and an in vivo microscope was placed on the lungs to measure alveolar mechanics. In the controlled mandatory ventilation group, multiple levels of positive end-expiratory pressure (PEEP; 5, 10, 16, 20, and 24 cm H2O) were tested. In the APRV group, decreasing durations of expiratory release (time at low pressure [T(low)]) were tested. The T(low) was set to achieve ratios of termination of peak expiratory flow rate (T-PEFR) to peak expiratory flow rate (PEFR) of 10%, 25%, 50%, and 75% (the smaller this ratio is [ie, 10%], the more time the lung is exposed to low pressure during the release phase, which decreases end-expiratory lung volume and potentiates derecruitment). Alveolar perimeters were measured at peak inspiration and end expiration using digital image analysis, and strain was calculated by normalizing the change in alveolar perimeter length to the original length. Macrostrain was measured by volume

Rannaprotsesside anatoomia laserskaneerimise skalpelliga / Maris Eelsalu, Artu Ellmann, Kalev Julge ... [jt.

Index Scriptorium Estoniae

2014-01-01

Ajavahemikus 2008-2013 Pirita rannas läbi viidud uurimuses demonstreeriti lennukil paikneva (ALS) ja rannale paigaldatud (TLS) mõõdistusseadmete abil tehtava laserskaneerimise võimalusi ranna kolmemõõtmelise topograafia ajaliste muutuste analüüsimiseks

Kliimasoojenemise hüsteeria läheb kalliks maksma / Kalev Kallemets

Index Scriptorium Estoniae

Kallemets, Kalev, 1979-

2009-01-01

Autori väitel tähendab praegune EL-i süsinikdioksiidi-kaubanduse kokkulepe Eesti elektrihinna 2-3-kordistumist 2015. või 2020. aastaks, 20% suurune emissioonikärbe ning süsinikdioksiidi kvoodi hinnatõus tähendab lööki Eesti ja Euroopa majandusele

Eesti majandus 1991-2007 : taassünd ja edulugu / Kalev Kukk

Index Scriptorium Estoniae

Kukk, Kalev, 1951-

2008-01-01

Ettekanne Rahvusarhiivi teaduskonverentsil "Kaks algust: 15 aastat iseseisvat Eesti Vabariiki" 23. novembril 2007. Eesti majandus 1980-ndate aastate lõpul, iseseisvuse esimestel aastatel ning pärast liitumist Euroopa Liiduga. Tabelid

Eesti lipu võib heisata iga päev / Kalev Uustalu

Index Scriptorium Estoniae

Uustalu, Kalev, 1951-

2006-01-01

Aasta alguses jõustunud Eesti lipu seaduses kehtestatud riigi- ja kohaliku omavalitsuse asutustele riigilipu kasutamise uutest reeglitest ning eraisikutele Eesti lipu kui rahvuslipu kasutamise vabadusest. Sama ka Hiiu Leht 3. veeb. 2006, lk. 8 ; Sakala 10. veeb. 2006, lk. 2 ; Lääne Elu 9. veeb. 2006, lk. 2 ; Järva Teataja 23. veeb. 2006, lk. 2 ; Pärnu Postimees 23. veeb. 2006, lk. 2 ; Linnaleht Tartu 24. veeb. 2006, lk. 6

Kulu- ja turupõhisest hinnakujundamise strateegiast turunduses / Mait Miljan, Kalev Kaarna

Index Scriptorium Estoniae

Miljan, Mait

2005-01-01

Tänapäevases ärikeskkonnas soovitavad autorid kasutada kombineeritud mudelit, milles rakendatakse kulu- ja turupõhist strateegiat lähtuvalt ettevõtte turusituatsioonist, tegevusvaldkonnast ning püütakse liikuda ühtse hinnakujundamiseni tarneahelas kui tervikus. Skeemid

Takistused ja tulemused piirangute teooria rakendamisel ettevõtete arendamiseks / Kalev Kaarna

Index Scriptorium Estoniae

Kaarna, Kalev

2005-01-01

Piirangute teooria on selgetel alustel põhinev juhtimiskontseptsioon, mis võtab arvesse ka inimkäitumist muutuste juhtimisel, keskendub ettevõtte tegevustulemuste hüppelisele paranemise saavutamisele läbi tegevuse fokuseerimise. Skeem. Tabel

Gerd Kanter alistas keerulised tuuled ja tugevad vastased / Peep Pahv

Index Scriptorium Estoniae

Pahv, Peep, 1970-

2008-01-01

Vt. ka Postimees : na russkom jazõke 17. märts, lk. 13. Maailmameister Gerd Kanter võitis viiendat korda Euroopa talvised karikavõistlused. Mihkel Kukk viskas oda 78.41 ning täitis Pekingi olümpia B-normi

Tunni analüüs - mis see on? / Peep Leppik

Index Scriptorium Estoniae

Leppik, Peep

2001-01-01

Tunni analüüs, õppe-kasvatustöö eesmärgid. Tunni analüüs on hinnangu andmine protsessidele, mille kutsub esile õpetaja tegevus (või tegevusetus) tunnis. Tunni läbiviimise protsessi mõjutavad õpilaste koosseis klassis, erinevate õppevormide ja õppemeetodite kasutamine, kasutatud õppevõtete otstarbekus, erinevad metoodikad ja õppesüsteemid

Kuulus velotuur võib jõuda Eesti teedele / Peep Pahv

Index Scriptorium Estoniae

Pahv, Peep, 1970-

2007-01-01

Vt. ka Postimees : na russkom jazõke 29. nov., lk. 12. Maailma mainekaima velotuuri Tour de France korraldajad on pöördunud Eesti kultuuriministeeriumi poole ettepanekuga alustada 2018. aasta võidusõitu Tallinnast

Eesti nimekaim ilukirurg jagab enesekindlust / Peep Pree ; intevjueerinud Priit Pullerits

Index Scriptorium Estoniae

Pree, Peep, 1958-

2006-01-01

Vestlus Tartu esteetilise kirurgia erakliiniku Clinica juhatajaga tööst, vastutustundest, ebaõnnestumistest. Kommenteerivad Tartu linnapea Laine Jänes ja Tartu Ülikooli arstiteaduskonna emeriitprofessor Ennu Sepp

``Peeps,'' cream, heads, and food coloring in a vacuum jar

Science.gov (United States)

DePino, Andrew

2001-01-01

This note describes some methods of adding interest to the standard vacuum jar demonstrations. Marshmallow animals, shaving cream, doll heads, and food coloring add some spark to these demos. These new twists have been well received by the students.

"Scientific peep show": the human body in contemporary science museums.

Science.gov (United States)

Canadelli, Elena

2011-01-01

The essay focuses on the discourse about the human body developed by contemporary science museums with educational and instructive purposes directed at the general public. These museums aim mostly at mediating concepts such as health and prevention. The current scenario is linked with two examples of past museums: the popular anatomical museums which emerged during the 19th century and the health museums thrived between 1910 and 1940. On the museological path about the human body self-care we went from the emotionally involving anatomical Venuses to the inexpressive Transparent Man, from anatomical specimens of ill organs and deformed subjects to the mechanical and electronic models of the healthy body. Today the body is made transparent by the new medical diagnostics and by the latest discoveries of endoscopy. The way museums and science centers presently display the human body involves computers, 3D animation, digital technologies, hands-on models of large size human parts.

Kuusalus saab rattad alla autotreileritööstus / Peep Talimaa

Index Scriptorium Estoniae

Talimaa, Peep

2008-01-01

OÜ-le Trucks & Trailers kuuluvast Kuusalu treileritehasest. Lisa: Kuusalu treileritehase ajalugu ja eellugu; Autotreileri valmimine; Üldandmeid treilerite kohta; Kuusalu treileritehase ajalugu ja eellugu

Jahindus = Hunting / Jüri Tõnisson, Kaarel Roht, Peep Männil

Index Scriptorium Estoniae

Tõnisson, Jüri, 1946-

2007-01-01

Jahimeeste poolt loendatavate ulukite arvukus ja küttimine. Statistilised andmed 1985-2005. aasta jahihooajast. Põdra arvukus ja küttimine 1960-2005. Erinevate jahiulukite populatsioonide seisund Eesti metsades. Tabelid, diagrammid, graafikud

Jahindus = Hunting / Jüri Tõnisson, Kaarel Roht, Peep Männil

Index Scriptorium Estoniae

Tõnisson, Jüri, 1946-

2008-01-01

Jahimeeste poolt loendatavate ulukite arvukus ja küttimine. Statistilised andmed 1985-2006. aasta jahihooajast. Põdra arvukus ja küttimine 1960-2006. Erinevate jahiulukite populatsioonide seisund Eesti metsades. Tabelid, diagrammid, graafikud

Kes kaitseks Eesti ohvitsere NKVD-KGB laimu eest? / Peep Varju

Index Scriptorium Estoniae

Varju, Peep

2008-01-01

Autor polemiseerib Eesti Ekspressis ilmunud artiklitega Eesti endiste ohvitseride kohta, kus käsitletakse nende väidetavat koostööd KGBga. Vaatluse all on ohvitserid Ain Mere, Harald Nugiseks, Alfons Rebane ja Harald Riipalu

Žürii kommenteerib Kultuurkapitali arhitektuuripreemiaid 2008 / Marika Lõoke, Laila Põdra, Liina Jänes... [jt.

Index Scriptorium Estoniae

2009-01-01

Peapreemia: Markus Kaasik, Andres Ojari, Ilmar Valdur, Mihkel Tüür, Kalle Komissarov (Pärnu Keskraamatukogu hoone), tegevuspreemia: Maarja Kask, Ralf Lõoke, Neeme Külm, Ingrid Ruudi (projekt Gaasitoru 11. Veneetsia arhitektuuribiennaalil), aastapreemia: Maarja Kask, Ralf Lõoke, Karli Luik (Tartu Kesklinna Kooli juurdeehitus) ja Peep Jänes (Raudna Põhikooli spordihoone), sisearhitektuuri preemia: Tea Tammelaan, Malle Jürgenson, Krista Lepland, restaureerimispreemia: Mari Hammer, Tiiu Lõhmus, Helve Ilves, Villu Kadakas (Vanalinna Hariduskolleegiumi hoone)

Rahvusooperi Estonia teatrihoone publikuruumide restaureerimistöödest / Liivi Künnapu

Index Scriptorium Estoniae

Künnapu, Liivi, 1953-

2006-01-01

Arhitektuuriajalooline ülevaade. 2005. a. restaureerimistöödest: garderoob-vestibüülist, peatrepist, ringfuajeedest, teatri- ja Valgest saalist, keldrikorruse ruumidest. Muinsuskaitse eritingimused, järelevalve: Liivi Künnapu. Projekteerijad: Peep Jänes, Indrek Suigussaar, AB Kolde Grupp. Sisekujundus: Juta Lember, Aulo Padar. Teostus: Koger ja Partnerid, projektijuht Indrek Võeras. Laemaali (E. Okas, E. Kits, R. Sagrits) restaureerimine, uuringud: KAR-Grupp. Akustik: Linda Madalik. Bibliogr. lk. 25. 8 vaadet

Experiential Marketing Sebagai Suatu Strategi Dalam Menciptakan Customer Satisfaction Dan Repeat Buying Untuk Meningkatkan Kinerja Pemasaran

OpenAIRE

Indriani, Farida

2006-01-01

Experiential marketing represent the alternative from excellence competition had by company as asset able to improve the marketing performance. Experiential marketing had by company can assist the company to peep out the new idea in each planning compilation, peculiarly in compiling marketing strategy. That way also by improving experiential marketing strategy continously, company quickly can anticipate the change that happened around company through the strategy which application. And with ...

Lastekirjandus vallutab uusi tippe : eesti lastekirjandus 2009 / Jaanus Vaiksoo

Index Scriptorium Estoniae

Vaiksoo, Jaanus, 1967-

2010-01-01

Ülevaade 2009. aasta eesti lastekirjandusest. Pikemalt käsitletakse järgmisi autoreid ja nende teoseid: Kadi Hinrikus "Kui emad olid väikesed", Kristiina Kass "Peeter ja mina", Mika Keränen "Varastatud oranž jalgratas", Andrus Kivirähk "Kaka ja kevad", Aino Pervik "Ühes väikses veidras linnas", Maarja Undusk "Päkapikk Ingo", Ilmar Tomusk "Vend Johannes", Indrek Koff "Enne kooli", Piret Raud "Härra Linnu lugu", Wimberg "Suur pidusöök", Artur Jurin "Puru kuningriigi lood II", Joonas Sildre "Maailma naba", kogumik "Uued eesti muinasjutud", Aino Pervik "Tirilinna lood", Aimeé Beekman "Päästekoer Walter", Eve Ernis "Karupoeg Nummi seiklused", Priit Aimla "Torisev vanatoi", Juhani Püttsepp "Väikese hundi lood" ja "Lauajupi Madonna", Epp Petrone "Siis, kui seened veel rääkisid", Heiki Vilep "Habemega nali", "Nõiutud linn", Leelo Tungal "Naljatilgad lähevad laulupeole", "Kama üks ja kama kaks", koos Peep Pedmansoniga Miriami lood"(esimene 3D-piltidega lasteraamat), Aidi Vallik "Pints ja Tutsik" 2. osa, Mare Müürsepp "Viis vaba kutsikat", Tiia Selli "Kass Kriibik", Aleksei Turovski "Kassipoeg Võilill", Kaider Vardja "Vana maja lugu", Merca "Mullivesi", Ülle Kütsen "Väike puu ja rändur kuu", Lehte Hainsalu "Mängiks midagi", Peep Veedla "Pöialpoiss"

Glutamine Attenuates Acute Lung Injury Caused by Acid Aspiration

Directory of Open Access Journals (Sweden)

Chih-Cheng Lai

2014-08-01

Full Text Available Inadequate ventilator settings may cause overwhelming inflammatory responses associated with ventilator-induced lung injury (VILI in patients with acute respiratory distress syndrome (ARDS. Here, we examined potential benefits of glutamine (GLN on a two-hit model for VILI after acid aspiration-induced lung injury in rats. Rats were intratracheally challenged with hydrochloric acid as a first hit to induce lung inflammation, then randomly received intravenous GLN or lactated Ringer’s solution (vehicle control thirty min before different ventilator strategies. Rats were then randomized to receive mechanical ventilation as a second hit with a high tidal volume (TV of 15 mL/kg and zero positive end-expiratory pressure (PEEP or a low TV of 6 mL/kg with PEEP of 5 cm H2O. We evaluated lung oxygenation, inflammation, mechanics, and histology. After ventilator use for 4 h, high TV resulted in greater lung injury physiologic and biologic indices. Compared with vehicle treated rats, GLN administration attenuated lung injury, with improved oxygenation and static compliance, and decreased respiratory elastance, lung edema, extended lung destruction (lung injury scores and lung histology, neutrophil recruitment in the lung, and cytokine production. Thus, GLN administration improved the physiologic and biologic profiles of this experimental model of VILI based on the two-hit theory.

Ernesto Achille Preatoni

Index Scriptorium Estoniae

2001-01-01

Äripäeva ajakirjanike Peeter Raidla, Sulev Olli, Peep Soomani ja Inno tähismaa artiklid Ernesto Preatoni tegevusest Eestis ja välismaal: Ühispanga hõivamine; Grandioossed plaanid; Sõprus Arco Varaga; Minek börsile ja naaberriikidesse; Kiire kõrvalpõige väikepankadesse; Oma panga loomine; Eesti kodaniku ajastu; Pro Kapitali kodusõda; Lõppvaatus ja Tallinna börsilt lahkumine; Pro Kapital tegutses; Võitlus eesti ajakirjandusega; Kaubanduskeskuse ja sinimajade tooja